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Analytical summary - The physical environment

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Ethiopia is one of the 52 countries in Africa that signed the Libreville Declaration on Health and Environment on 29 August 2008. Ethiopia has also been part of an international initiative to prevent environmental degradation, both at local and global level. The Ministry of Health and the Ethiopian Environmental Protection Authority are the leading institutions working on health and environmental health.

The most obvious environmental risk factors affecting human health in urban settings are hazardous wastes from industry and transport, and poor chemical and household waste management. Indoor air pollution and poor housing, food contamination and disease vectors are also risk factors. Toxic wastes are most common in Addis Ababa where industries, automobiles and hospitals are concentrated.

According to the Ethiopian Environmental Protection Authority, 1 847 288 m3 of hazardous liquid waste and 19 150 tonnes of solid hazardous wastes were generated from industrial sectors in 2006. The high risk factors in rural setting are attributed to the use of biomass fuel (indoor pollution), soil degradation, biodiversity loss, deforestation, drought, poor housing and disease vectors. The estimated number of deaths associated with indoor and outdoor air pollution in 2004 was 72 400 and 2 500, respectively.

Poor sanitation and hygiene is also a major problem in Ethiopia. The number of children dying each year from diseases related to sanitation and hygiene accounts for 60% of the total deaths. However, only 1% of the total health budget is allocated to improving sanitation and hygiene.

An increase in global mean temperature has created conducive ecological conditions for vector breeding and the consequent spread of vector-borne diseases, of which malaria is the most prevalent. Three quarters of the country is considered to be either malarious or potentially malarious and two thirds of the population is at risk of malaria infection. Malaria was the top leading cause of outpatient visits in 2007–2008, accounting for 12% of the total outpatient morbidity.[1] Anomalous climatic change, increase in water development schemes, unaffordability and shortage of new antimalarial drugs, and inadequate supply of insecticide-treated bednets contribute to the high prevalence of malaria in Ethiopia.

However, malaria is being controlled with a three-pronged approach, consisting of early diagnosis and effective treatment, selective vector control and epidemic prevention and control. The Government of Ethiopia aims to eliminate malaria from the country by 2020.

In addition to malaria, other vector-borne diseases such as onchocerciasis, dracunculiasis and trachoma are also common.

Some observed gaps in the prevention and control of health and environmental risk factors include:

  • lack of adequate and regular environmental surveillance activity;
  • lack of a national performance monitoring and evaluation mechanism for priority programmes related to health and the environment;
  • absence of reporting or monitoring mechanisms for status and enforcement;
  • no research guidelines and agenda on the link between health and environment.

In addition, environmental strategic plans do not address risk factors that have implication on health and vice versa and, as a result, there is no integrated advocacy of health and environment issues. However, the country has environmental impact assessment laws and procedures and as a component of the National Science and Technology Policy there is a research agenda that gives specific consideration to health and the environment.

The way forward

  • Build professional capacity in the field of health and the environment by strengthening the capacity of existing training institutions.
  • Mobilize substantial financial resources to facilitate collaborative surveillance activities to support and manage research on the link between health and the environment and for advocacy on the link between health and the environment.
  • Strengthen the mechanism to enforce compliance of multilateral environmental agreements and allocate specific technical, human and financial resources to support the existing national implementation plan for the three conventions.


  1. Health and health-related indicators, 2008. Addis Ababa, Government of Ethiopia, Ministry of Health, 2008