Ethnic Regionalization & Its Ramification on Health: A Study of Malaria Epidemics in Ethiopia

By Dr Assefa Negash
I. Introduction: The Scourge of Malaria

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Dr Assefa Negash

In 1956, the World Health Organization (WHO) embarked upon an ambitious malaria eradication program. Although the program resulted in a significant decline in the incidence of the disease between 1956 and 1968, an increasing resurgence of the disease has been witnessed in recent years and continues to pose a major threat to public health in many tropical and sub-tropical areas. Approximately 300 million people worldwide are affected by malaria each year.

In Africa alone, some 200 million people are affected by it and the continent accounts for the majority of the estimated 2 to 3 million people who die from the disease.

Malaria is currently a major leading cause of mortality in Ethiopia second only to tuberculosis in the numbers it kills. It has been a major public health problem for decades: Ethiopia was hit by malaria epidemics in 1958, 1965, 1973 and 1981/1982 and recently in 1995/1996. Recently there have been reports of Epidemics in Ethiopia outbreaks of malaria epidemics claiming many lives in different parts of Ethiopia.

Approximately, 75% of the total topographic area of Ethiopia is suited for the transmission of malaria, primarily areas below an altitude of 2,000 meters. The gradient of the Ethiopian highlands is such that it causes rapid run-off which precludes the creation of standing waters in areas above 2,000 meters, thereby denying the mosquitoes niches in which to breed. If one looks at the pattern of settlement in Ethiopia, one observes that the majority of the Ethiopian population is concentrated in the densely populated highland regions where exposure to malaria is less likely. Unable to protect themselves against deadly tropical diseases in the low lands, the majority of Ethiopians have been forced to live in the highland regions, thus bringing heavy pressure to bear upon sometimes fragile environmental conditions of the highlands.

The proliferation of deadly vector-borne diseases such as malaria has thus indirectly contributed to the ecological degradation, in some places irreversibly, of the highland regions of Ethiopia. At the same time, the increasing desertification of the highland regions in recent decades has brought with it demographic expansion into malarious areas. Presently, approximately 64% of the Ethiopian population live in malarious regions. Following the successful efforts to control malaria and other vector-borne diseases in the last four dec11des, many Ethiopians from the densely populated highland regions began to move and settle in the low lands (the Awash valley, Humera, the Rift Valleys, etc.). Therefore the current outbreaks of malaria epidemics in many regions of Ethiopia signal a serious decline in the efficacy of the efforts to control malaria and other vector-borne diseases. There is a political cause to this decline. To understand this regression, it is necessary to provide some background information. ….. (Read more, PDF)

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