Attachments
Highlights
• Humanitarian needs across Eastern and Southern Africa Region (ESAR) reached unprecedented levels due to alarming increase in disease outbreaks, climate shocks, conflict and displacement, and economic instability, further deepening vulnerabilities among the most at-risk children and women. In 2024, 14.5 million people and 6.6 million children were in need of humanitarian assistance.
• Widespread public health emergencies were reported across 20 out of 21 countries in Eastern and Southern Africa, with outbreaks of cholera, Mpox, Marburg Virus Disease (MVD), polio, among others. This heightened vulnerability was exacerbated by weak health systems, climate shocks, and inadequate sanitation, particularly impacting children and marginalized communities.
• Conflict in Sudan continued to impact the region, particularly in the neighboring countries of Ethiopia, South Sudan, Eritrea and Uganda, straining the existing resources and response capacities.
Regional Situation Overview and Humanitarian Needs
The humanitarian situation in Eastern and Southern Africa (ESA) remains vast and multidimensional, driven by climate shocks, public health outbreaks, food insecurity, civil and political unrest, conflict, and economic deterioration. In 2024, the Southern Africa region experienced its driest month (February) in over a century and 20 out of 21 countries were facing public health outbreaks. This report provides an overview of the humanitarian situation and response across 12 countries—Angola, Botswana, Burundi, Comoros, Eritrea, Eswatini, Lesotho, Namibia, Rwanda, South Africa, Tanzania, and Zambia—under the UNICEF Eastern and Southern Africa Region’s 2024 Humanitarian Action for Children Appeal.
Public health emergencies—including outbreaks of cholera, polio, Marburg virus disease, mpox and other diseases— continued to threaten vulnerable populations across Eastern and Southern Africa. The region remains highly susceptible to recurrent disease outbreaks, particularly in countries with severe flooding, poor sanitation infrastructure, and weak health systems. By the end of 2024, 20 countries had active public health events, further deepening the vulnerability of affected communities. The region reported the highest cholera/acute watery diarrhea related deaths globally, with 13 countries facing cholera outbreaks and a combined case fatality rate of 1.5 per cent. In addition, on 14 August 2024, WHO declared a public health emergency of international concern for mpox. In Eastern and Southern Africa, more than 3,280 Mpox cases were reported across 8 countries in the region (Angola, Burundi, Kenya, Rwanda, South Africa, Uganda, Zambia and Zimbabwe). Following the activation of a Level 3 emergency, UNICEF supported affected countries in scaling up the delivery of a multi-sectoral humanitarian response in three of the most affected countries: Burundi, Rwanda and Uganda. Compounding these public health outbreaks, the third largest record outbreak of Marburg occurred in Rwanda with over 66 confirmed cases and 15 deaths (and a case fatality rate of 22.7 per cent). UNICEF continued to play a key leadership role at regional and country levels in ensuring effective coordination, especially in WASH, nutrition, health, and risk communication and community engagement (RCCE) across the region to strengthen disease surveillance, improve sanitation and water access, and ensure timely emergency health responses.
The crisis in Sudan continued to have cross-border implications for neighbouring countries in the region, particularly, South Sudan, Ethiopia,Eritrea and Uganda in 2024. As conflict and insecurity continue to displace millions within Sudan,Ethiopia, South Sudan, Uganda and Eritrea have experienced a surge in refugees fleeing the violence. Uganda, already home to one of the largest refugee populations in Africa, has seen an influx of Sudanese and South Sudanese refugees, placing additional pressure on already strained resources. Similarly, Eritrea is facing increased refugee flows, exacerbating existing humanitarian needs and further stretching country’s limited capacity to respond and to ensure the protection and well-being of affected populations.
The confluence of El Niño-induced drought, inflation, high fuel prices, and an unstable macroeconomic environment have severely impacted the ability of households to meet their food requirements across the region. Adolescent girls have been particularly vulnerable, facing multiple sexual and reproductive health and rights (SRHR) risks, including increased gender-based violence (GBV), transactional sex resulting in increased HIV cases, and early pregnancy.
Heavy rains and flooding from March to May 2024 devastated countries in Eastern Africa, especially Burundi, Rwanda, and Tanzania, affecting more than 304,000 people and resulting in the loss of lives, displacement, and destruction of schools. At the regional level, UNICEF worked closely with the Southern Africa Development Community (SADC) in planning, communication, advocacy, and resource mobilization, supporting the development of the regional SADC appeal and providing capacity-building assistance on disaster risk reduction (DRR) and anticipatory actions.
In 2024, country offices in ESA continued to focus on strengthening risk analysis and preparedness capacity. Countries such as Angola, Madagascar, and Namibia scaled up anticipatory action interventions to address the impact of El Niño-induced drought. This represents a transformative approach in humanitarian response, emphasizing a paradigm shift from reactive to proactive measures to mitigate or prevent some of the impacts of predictable crises before they fully unfold, while saving lives, reducing needs, and safeguarding development.