Lema Tefera’s voice trembled as he recounted the unimaginable loss of four children to malaria within a single month—deaths that could have been prevented if not for the ongoing conflict in Ethiopia’s Oromia region.
“There was no malaria medication or treatment in our village due to the fighting,” the farmer told AFP over the phone.
Africa bears the brunt of malaria worldwide, accounting for 95% of the 250 million cases and over 600,000 deaths annually, according to the World Health Organization (WHO). In Ethiopia, the situation is rapidly deteriorating, particularly in Oromia, where a violent conflict between the government and the Oromo Liberation Army (OLA) has raged since 2018, crippling healthcare services.
Doctors, health experts, and aid workers warn that the surge in malaria fatalities is fueled by a “perfect storm” of war and climate change. Subsistence farmers like Lema, who had seven children before the disease took four of them, are especially vulnerable.
“It was the worst situation I have ever experienced,” Lema said.
Ethiopia recorded approximately 7.3 million malaria cases and 1,157 deaths between January and October 2024, with figures doubling since 2023. Oromia alone accounts for nearly half of these cases and fatalities.
The region, covering more than a third of Ethiopia, has seen a devastating collapse of healthcare infrastructure. Gemechu Biftu, executive director of the Oromia Physicians Association, noted that the conflict has severely disrupted the supply of anti-malarial drugs.
Meanwhile, peace remains elusive. The Ethiopian government has classified the OLA as a terrorist organization, and peace talks held in Tanzania in 2023 failed to bring an end to the violence.
Legesse Bulcha, director of Nejo General Hospital in West Wollega—one of the hardest-hit areas—reported a dramatic rise in malaria cases over the past three years. Malaria now accounts for 70% of the 26,000 patients treated at his hospital between 2023 and 2024, compared to just 20% in previous years.
In addition to war, shifting climate patterns are exacerbating the crisis. Experts warn that rising temperatures and prolonged wet conditions are creating a breeding ground for malaria-carrying mosquitoes.
“Unlike before, there are still significant numbers of cases during the dry season,” Legesse observed. Gemechu added that malaria is not only becoming more lethal but also spreading to previously unaffected areas.
Doctors Without Borders (MSF) Ethiopia coordinator, Rachelle Seguin, described 2024 as likely recording the country’s highest-ever malaria cases.
“You have increasing temperatures, and you’ve had conflict in the country for years. It’s a little bit of a perfect storm,” Seguin said, fearing the situation could worsen with the upcoming rainy season from June to September.
The crisis has been further compounded by the sudden suspension of US aid, previously a major contributor to malaria prevention efforts. The funding freeze, ordered by former US President Donald Trump, has left critical health programs in jeopardy.
“The recent USAID funding cut would significantly increase morbidity and mortality not only from malaria but also from other communicable diseases,” warned Oromia-based doctor Nuredin Luke. The US had previously provided around 40% of global malaria research and control funding, but it remains uncertain if this support will resume.
For Lema, far removed from global politics, the grief is overwhelming. Unable to farm due to the crisis, he now relies on relatives for survival.
“I have been completely depressed,” he admitted. “I have not been able to recover from the grief.”
