Originally published 2022-03-18.
In mid-March 2022, at a press briefing in Geneva, World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus said there was "nowhere on earth where the health of millions of people is more under threat than in Tigray." He was speaking about the northern region of Ethiopia, which by then had been largely cut off from food, medicine, fuel, banking and communications for months during a civil war. Tedros, who is himself from Tigray, called on Ethiopia and Eritrea to end the blockade and let aid and aid workers in.
His warning came at a time when the world's attention was fixed on Russia's invasion of Ukraine. This article explains what he said and why, the background to the Tigray war, the controversy around Tedros's own role, and what happened after his appeal.
What the WHO chief said
Tedros opened by acknowledging his personal connection. "Yes, I'm from Tigray. And this crisis affects me, my family and my friends very personally," he said, before stressing that his duty as head of the WHO was to defend health wherever it was threatened.
He then drew a direct comparison with the war in Ukraine. Just as the WHO was urging Russia to make peace, he said, it was urging Ethiopia and Eritrea to lift the siege of Tigray and allow safe passage for humanitarian supplies and workers.
The practical situation he described was stark. According to the WHO, no UN emergency food convoys had reached Tigray since mid-December 2021. Some medical supplies had been flown in, but far too little to meet the needs of a population of around six to seven million people. Health workers reported hospitals running out of basic drugs, fuel and equipment, and many clinics had been damaged or looted during the fighting.
The Tigray war in brief
The conflict began on 3 November 2020, when forces loyal to the Tigray People's Liberation Front (TPLF), the party that governed the region, attacked bases of the Ethiopian army's Northern Command, including its headquarters in the regional capital Mekelle. Prime Minister Abiy Ahmed's government responded with a military offensive. Troops from neighbouring Eritrea entered northern Tigray in support of federal forces, along with regional forces from Amhara.
The war became one of the deadliest of the 21st century. Human rights groups documented mass killings, including the massacre in the historic town of Axum, widespread sexual violence and the destruction of farms and clinics. Ethiopia and Eritrea have both denied allegations of genocide. Estimates of the total death toll vary enormously: researchers at Ghent University estimated between 162,000 and 378,000 deaths from violence, famine and lack of medical care, while the African Union's chief mediator, former Nigerian president Olusegun Obasanjo, said around 600,000 people may have died.
Hunger was a central part of the crisis. As early as March 2021, the UN estimated that about 4.5 million people in Tigray needed aid. A federal blockade later stopped most supplies from reaching the region, and aid workers repeatedly warned of famine conditions.
Tedros, Tigray and the accusations against him
Tedros was born in 1965 in Asmara, then part of Ethiopia and now the capital of Eritrea, to a family from Tigray. He was a member of the TPLF and built his career in Ethiopian public health, heading the Tigray regional health bureau before serving as Ethiopia's health minister from 2005 to 2012 and foreign minister from 2012 to 2016. In 2017 he became the first African to lead the WHO.
That background made his comments politically sensitive. Abiy Ahmed's government accused Tedros of siding with the TPLF. In November 2020, Ethiopia's army chief publicly claimed he was helping the Tigrayan forces, which Tedros denied. In January 2022, the government formally asked the WHO to investigate him for alleged misconduct and for spreading what it called harmful misinformation. Some early retellings of the story mixed this up and described the prime minister as the one accused; the accusations were in fact made against Tedros, by the Ethiopian government.
WHO member states did not act on the complaint. In May 2022, two months after his Tigray appeal, Tedros was re-appointed unopposed for a second five-year term. He had earlier described the blockade, which left millions without food, medicine, electricity and telecommunications for more than a year, as "an insult to our humanity."
What happened after the appeal
About a week after Tedros spoke, on 24 March 2022, the Ethiopian government declared an indefinite humanitarian truce to allow aid into Tigray. Some convoys did get through, but the World Food Programme reported that deliveries rarely reached those most in need, largely because fuel was not allowed in. Hostilities escalated again in August 2022, and in September Ethiopian and Eritrean forces launched a joint offensive in northern Tigray.
On 2 November 2022, the federal government and the TPLF signed a permanent cessation of hostilities in Pretoria, South Africa, after talks led by the African Union and backed by the United States, with Obasanjo as chief mediator. The deal provided for the disarmament of Tigrayan fighters and the restoration of federal authority, and an Interim Regional Administration led by Getachew Reda replaced the previous Tigray government.
Aid deliveries resumed after the signing, and banking, electricity, telecommunications, flights and transport to Mekelle were gradually restored. Food aid was later suspended for a period over reports of large-scale theft and diversion. Eritrea was not a party to the Pretoria agreement, and its troops were reported to remain in parts of Tigray afterwards.
Why "nowhere on earth" mattered
Tedros's phrase was a deliberate attempt to shift attention. Humanitarian crises compete for headlines, funding and political will. In March 2022, Ukraine dominated the news, and aid agencies feared that Tigray, along with crises in Yemen, Afghanistan and Somalia, would be forgotten.
When reading appeals like this, it helps to ask three questions. First, what is being blocked: food, fuel, medicine, cash or communications? Second, how much aid was promised compared with how much actually arrived and was distributed? Third, who is responsible for access? In Tigray, the answers in early 2022 pointed to a siege that affected every part of daily life, with very little getting through, and with the federal government and Eritrea controlling the routes in.
How to follow the situation responsibly
Information from Tigray was extremely difficult to verify during the war, because the internet and phone networks were shut down and journalists were largely kept out. Reliable sources for ongoing updates include UN agencies such as OCHA, the WHO and the World Food Programme, established humanitarian organisations, and major international news outlets that state clearly how they obtained their information.
Readers who want to help can support recognised humanitarian organisations working in Ethiopia, and be cautious about unverified casualty figures or images shared on social media, which during the conflict were often recycled from other places or years.
Sources: The Guardian: Nowhere on earth are people more at risk than Tigray, says WHO chief (March 2022) · Wikipedia: Tigray war · Wikipedia: Tedros Adhanom Ghebreyesus · Heinrich Böll Stiftung: The Pretoria Agreement for Tigray, one year after (November 2023)
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