Case Study: Climate-Informed Early Warning and Response Systems for Malaria in Ethiopia

Climate change and its impacts pose significant risks for malaria control and elimination programs. There are inextricable links between weather, climate, the environment and malaria, with threats that are growing. For instance, some models show that by 2030, increased temperatures may put up to 61 million additional people at risk for endemic malaria transmission and another 48 million additional people at risk for seasonal transmission.

In Ethiopia, where cases have surged in part due to climate factors, more than 52% of the population was estimated to be at risk of infection in 2023. Early warning systems that leverage Climate Information Services (CIS) can help reduce this national malaria burden. Additionally, targeted and concentrated surveillance can create an opportunity to control outbreaks as they happen while also reducing the risk of novel outbreaks. The Ethiopian Public Health Institute (EPHI) and its Public Health Emergency Management (PHEM) Center are collaborating with diverse partners in new ways to continuously improve climate-informed national early warning and response systems for malaria, as well as other climate-sensitive diseases.

The U.S. President’s Malaria Initiative (PMI), which is led by the United States Agency for International Development (USAID) and implemented together with the Centers for Disease Control and Prevention (CDC), has heavily invested in malaria control and surveillance in Ethiopia and is supporting these efforts. Based on a pilot conducted by a research team at the University of Oklahoma, EPHI has rolled out an innovative malaria early warning tool tailored to public health staff and community health workers at the national and regional levels.

The Epidemic Prognosis Incorporating Disease and Environmental Monitoring for Integrated Assessment (EPIDEMIA) tool integrates malaria surveillance and climate data to generate forecasts and produce malaria early warning reports with up to 8-12 weeks lead time. Piloted first in the Amhara region of northern Ethiopia and later in Oromia, the state surrounding the capital- Addis Ababa, EPIDEMIA is now being scaled to the national level. The development of a roadmap to assess and support pathways for national scale-up was supported by PMI and USAID.

The implementation of the EPIDEMIA malaria early warning system has required a range of resources, including national leadership, committed partner support, sustained financing, and dedicated training for public health practitioners operating in a context of high turnover.