Health and politics in pandemic times: COVID-19 responses in Ethiopia

Abstract

With a focus on responses to coronavirus disease 2019 (COVID-19) in Ethiopia and on political developments that have occurred in the country during the pandemic, this article contributes to the existing scholarship that explores the relationship between health and politics. Drawing on qualitative data from the project ‘COVID-19 Impact Tracing in Ethiopia: Social, Economic, Political, and Security Ramifications’, carried out in the Tigray, Amhara and Oromia Regional States (RS) from June to September 2020, we offer new empirical and theoretical perspectives that shed light on the political status of health and health policies in Ethiopia and beyond. In all the three regions, COVID-19 and the government’s pandemic response was subject to politicization and securitization. The degree of securitization and politicization differed between the regions and fluctuated over time; in areas with strong opposition to political authorities, the COVID-19 mitigating efforts were—during the first phase of the pandemic—more politicized and securitized than in areas with less opposition. Yet, as the political opposition and instability increased, threatening national security and Prime Minister Abiy Ahmed’s political project, the authorities and the public paid increasingly less attention to the pandemic and the mitigating policies. In our analysis of these dynamics, we draw on a classic distinction that scholars of global public health have borrowed from political science: that of ‘low’ and ‘high’ politics. We argue that a contextually situated use of the high/low distinction allows us to recognize the fleeting and context-dependent nature of health’s political status, providing valuable insights that help us understand the ways that health emerges and disappears as high politics. The temporal and inter-regional shifts that appeared in, and as a response to, Ethiopia’s pandemic policies illustrate the importance of a continuous analysis of the relationships between health and politics at national as well as at sub-national levels.

Riding the Pandemic Waves—Lessons to Be Learned from the COVID-19 Crisis Management in Romania

“…However, government pandemic management was inconsistent in 2020 and 2021 due to government instability, as well as low levels of public trust, coupled by reduced willingness to enact unpopular lockdowns close to parliamentary election [ 49 ]. Government instability and low trust in government have also made it difficult for other low- and middle-income countries to manage a pandemic [ 70 ]. According to the analysis of Badman and colleagues, trust in national and local public health institutions needs to be developed to increase the population’s willingness to cooperate with non-pharmaceutical measures.…”

Politics–evidence conflict in national health policy making in Africa: a scoping review

“…Several studies have revealed that public health policies and systems appear to be built loosely on technical and scientific evidence, but with high political systems and ideologies [ 13 – 16 ]. For instance, in most African countries such as Ghana, Kenya, Nigeria, South Africa, Tunisia, and Zimbabwe, the management of the novel SARS-CoV-2 pandemic and the public health response have been heavily politicized [ 16 – 18 ].…”

“…Several studies have revealed that public health policies and systems appear to be built loosely on technical and scientific evidence, but with high political systems and ideologies [ 13 – 16 ]. For instance, in most African countries such as Ghana, Kenya, Nigeria, South Africa, Tunisia, and Zimbabwe, the management of the novel SARS-CoV-2 pandemic and the public health response have been heavily politicized [ 16 – 18 ]. Regardless of the seeming increase in research evidence on the central role of political leadership in defining national public health policies in Africa, there seems to be inadequate empirical accounts of the common themes or concepts in the existing literature regarding the politics–evidence conflict in the public health policy-making process [ 18 , 19 ].…”

“…Furthermore, while studies on health systems strengthening gave prominence to the role of technical knowledge in public health policy effectiveness, evidence on how politics shapes health systems is unclear [ 20 , 21 ]. However, such health development in Africa is largely driven by politics [ 16 – 18 ]. Clearly, there is the need to establish the common themes and concepts that cut across the existing literature on the subject under discussion.…”

Conflict Settings and COVID-19’s Effects on Psychological Health

“…Since November 4, 2020 war has been started following Ethiopian Northern Command attack by Tigray People Libration Front (TPLF). A millions were displaced, thousands massacred, all public and private infrastructures destroyed in the conflict setting, children were raped in group, thousands killed [3,4]. This in turn highly influences the mental well-being of conflict-affected people in Ethiopia during COVID-19 era.…”