Ethiopia: Country Profile
Ethiopia is a large country in eastern Africa with a population of 115 million people. The country has the largest livestock population in Africa with 80% of Ethiopians having direct contact with livestock or domestic animals (1). Ethiopia joined the Global Health Security Agenda (GHSA) in 2014. The four One Health stakeholders met in 2015 for a zoonotic disease prioritization workshop to identify the zoonotic diseases of greatest concern (priority zoonotic diseases, PZDs) across the sectors. The workshop involved the Ethiopian Public Health Institute (EPHI), Ministry of Agriculture (MOA) formerly Ministry of Livestock and Fishery Resources, Ethiopia (MoLFR), and the Environment Protection Authority previously Ethiopian Ministry of Environment, Forest and Climate Change (MEFCC) and other partners including UN agencies such as the Food and Agricultural Organization (FAO), World Health Organization (WHO), and CDC. GHSA stakeholders have adopted the One Health approach in Ethiopia, which acknowledges the deep interconnectedness between human health, animal health, and the environment and the need for a multisectoral approach to prevent and address zoonotic diseases.
Priority Zoonotic Diseases
In the 2015 ZDs prioritization workshop identified five PZDs: rabies, anthrax, brucellosis, leptospirosis, and echinococcus, with a later shift to add avian influenza, and rift valley fever in place of leptospirosis, and echinococcus, in 2019.
Rabies remains a widespread disease worldwide, responsible for tens of thousands of deaths each year. Caused by a virus and affecting mammals, it is most often transmitted to humans via dog bites. In Ethiopia, it is estimated that at least 2,700 human deaths occur annually due to rabies.
Anthrax is a bacterial infection that typically affects animals and can pass from animals and animal products to humans, with limited human-to-human transmission. In endemic settings, anthrax affects primarily cattle, goats, sheeps and the spores can remain in soil for years. It can spread to humans through open wounds on the skin, ingestion, or inhaling the spores. Using surveillance data (2009-2013) from the Ethiopian Public Health Institute and the Ministry of Agriculture, a total of 5,197 human and 26,737 animal anthrax cases (human to animal ratio 1:5) were reported with 86 human anthrax deaths. The national human anthrax case prevalence was found to be 1.3 per 100,000 populations per five years.
Brucellosis is a bacterial infection with a global incidence of about 500,000 cases per year worldwide and a prevalence of more than 10 cases per 100,000 population in some countries. Humans become infected through contact with sick animals, ingestion of fresh unpasteurized or unboiled/raw milk, or fresh cheese. Brucellosis has a significant impact on the health and productivity of livestock, thus greatly reducing their economic value and work performance.
Avian influenza is an infection by an influenza virus that can affect almost all species of birds, wild or domestic. It can be highly contagious, especially in chickens and turkeys, and can lead to extremely high mortality, especially in commercial farms.
Rift Valley Fever (RVF) is a viral infection that spreads most commonly to humans from livestock or wild animals via mosquitoes. It can also be spread through direct contact with blood or bodily fluids of animals such as sheep, goats, or camels. RVF can cause spontaneous abortion in animals, and assisting with abortions is a common exposure. Farmers, abattoir workers, and veterinary or laboratory staff are high risk groups. Mosquito control and wearing protective equipment when exposed to blood or bodily fluids of infected animals are the main prevention methods.
Find a more detailed profile of anthrax, brucellosis, and avian influenza in Ethiopia in the landscaping report.
One Health Landscape
There are 12 key organizations actively involved in One Health activities in Ethiopia based on the landscaping report, and a summary of current partners can be found on the One Health Ethiopia website. One Health stakeholders coordinate their efforts through several communication platforms, summarized in this story.
Click on the image to advance through each page of One Health stakeholders.
Summary of existing research
LifeStock International, the EPHI, and the NVI implemented a survey of farmers in 2019 to explore knowledge and awareness of anthrax as well as attitudes and practices related to anthrax and the anthrax vaccine. The research team collected data from 48 farmers (survey) and 16 stakeholders working in sectors relevant to anthrax control (key informant interviews). The study found low awareness among farmers of anthrax including transmission and prevention topics. Respondents reported practicing risk behaviors such as consuming meat from infected carcasses. Reporting of anthrax cases typically stopped at the level of local leaders, limiting surveillance capacity. Willingness to vaccinate animals was low, except in areas where there had been recent cases of anthrax.
The Ministry of Health and Ministry of Agriculture in collaboration with the Centers for Disease Control and Prevention (CDC) and Ohio State University conducted a study in 2018 to estimate brucellosis prevalence in households who own livestock and identify risk factors for Brucella infection in humans and livestock. In three sites, the research team collected data on risk factors and household demographics, animal information, and seroprevalence of Brucella antibodies. The South Ethiopia site had the highest prevalence of brucellosis in both humans and animals followed by Amhara and Central Oromia; 15% of humans overall had detectable Brucella antibodies. The majority of individuals (68%) reported consuming raw milk and 61% reported participating in animal slaughter, both risk factors for brucellosis.
Other insights and resources can be found on the One Health Ethiopia website.
Case study on SBC response
Based on the landscaping analysis and the contributions of several stakeholders working in the One Health arena in Ethiopia, the Federal Ministry of Health and other departments and partners developed the National Zoonotic Diseases Message Guide. The guide is a reference document of accurate and standardized health information in simple language about anthrax, brucellosis, avian influenza, RVF, and rabies for an Ethiopian audience.
In addition to the PZDs message guide the national One Health Communication taskforce has developed national One Health risk communication strategy. This strategy provides guidance on implementation of risk communication activities at national and subnational levels.
The Breakthrough ACTION project supported community workers through a One Health risk communication training, which led a variety of community education and dialogue activities and even behavior change around eating the meat of sick or dead animals. Read the full story about the training and its positive outcomes here.