During my visit to Ethiopia, I met with the Bahir Dar University’s academic V/President, Professor Essey Kebede, along with the Director General (DG) of the APHI (Amhara Public Health Institute), Mr. Belay Bezabih Beyene, and academic staff and researchers from both institutions. Their discussions focused on potential areas of collaboration, including developing predictive models to assess the impacts of climate change on malaria and cholera outbreaks in the region.
Malaria and cholera are the top priorities of epidemic-prone diseases, significant and recurring public health problems in Ethiopia, particularly in the Amhara regional state. The region is characterized by a high malaria burden, with 80% of the regional landmass being favorable for malaria transmission, and 80% of the region's population is at risk of Malaria. In 2025/26, the region contributed 20-43% of the national malaria burden. In 2026, a total of 931,478 malaria cases and 19 deaths have been reported in the region. A total of 13,092 cholera cases were reported between July 22, 2023, and September 13, 2025, with a male-to-female ratio of 1.4:1. The overall cholera incidence rate was 93 cases per 100,000 population, with the highest rates observed in Quara district (2,116/100,000) and West Armachiho district (981/100,000) districts, respectively (2023-2025 APHI’s cholera report).
Malaria and cholera resilience in the Amhara Region is shaped by the capacity of communities and local health systems to sustain prevention measures while adapting to changing transmission dynamics driven by environmental and social conditions. Resilience is strengthened through community awareness and health education delivered via schools, religious institutions, women’s groups, and community meetings. These platforms help to improve early recognition of infection symptoms, encourage timely care-seeking, and promote preventive behaviors such as consistent net use, Oral Cholera Vaccine (OCV) campaigns, and environmental management around targeted areas for minimizing disease transmission, such as breeding sites for mosquitoes and the bacteria causing cholera. Building on community-based approaches, emerging evidence highlights the potential of participatory surveillance and citizen science to further strengthen malaria resilience by transforming communities from passive recipients of interventions into active contributors to data generation and response
A key finding from the discussions is that infection control becomes more sustainable when communities are actively involved in planning, implementation, and monitoring. Local volunteers help identify prevention gaps, and community participation ensures that interventions remain responsive to seasonal and localized transmission risks. However, declining risk perception and reduced engagement can weaken these gains, highlighting the need for continuous mobilization and adaptive strategies.
Infectious diseases such as malaria and cholera remain major and increasingly complex public health challenges in Ethiopia, particularly in the Amhara Region, where environmental, climatic, and socio-political factors strongly shape transmission. Seasonal peaks linked to heavy rainfall and flooding create ideal conditions for mosquito breeding and water contamination, while conflict-driven population displacement disrupts access to clean water, sanitation, long-lasting impregnated nets (LLINs), and healthcare, amplifying vulnerability.
These challenges are further intensified by limited health infrastructure, such as limited real-time surveillance digital tools, prevention, and response capacities. Scientifically, growing evidence shows that climate change is altering infectious disease dynamics by modifying temperature profiles, precipitation patterns, and the frequency of extreme weather events, which can expand transmission zones, prolong seasonal exposure, and increase outbreak risks.
However, a critical gap persists in the Ethiopian context: predictive models that accurately capture these complex, localized interactions between climate variables, environmental conditions, and epidemiological trends remain underdeveloped and insufficiently validated. Addressing this gap requires integrated, data-driven approaches that combine multisource datasets, including meteorological, geospatial, and health data, with advanced modeling techniques to generate reliable forecasts.
A key solution pathway lies in the co-development of user-centered digital health systems, such as mobile health (mHealth) applications, that translate predictive outputs into actionable, location-specific insights for both communities and decision-makers. By embedding early warning systems, real-time surveillance, and hotspot detection into accessible digital platforms and by engaging researchers, public health institutions, NGOs, and local communities in their design, these tools can strengthen preparedness, enable targeted interventions, and enhance adaptive responses to the evolving impacts of climate change on infectious disease transmission.
As a postdoctoral researcher in Data4Healthcare at the University of Oulu, I have been given a valuable opportunity to observe and understand how the healthcare system operates and evolves in Finland. This experience has also enabled me to build networks with researchers working on the development of resilience mechanisms, healthcare system early warning techniques, and mobile applications, particularly for use in developing countries such as Ethiopia, especially the Amhara region.
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Writer of this blog post is Haile Fenta, a postdoctoral researcher at the Center for Environmental and Respiratory Health Research, University of Oulu. His visit was supported by FRONT ROAM, which facilitated his collaboration with both institutions.
The Exploring resilience blog discusses the current themes of research, teaching and development of resilience, i.e., crisis resistance and deepens knowledge about the management of global change, and possible solutions to the wicked problems of sustainability. The authors are researchers and experts in the field, and members of the cooperation networks of the University of Oulu’s FRONT PROFI7 research programme.