Recent accounts of escalating conflicts across Ethiopia, including drone strikes, heavy fighting, and extrajudicial killings, risk causing immediate and severe health harms to affected communities, including a recurrence of widespread sexual and reproductive violence, said Physicians for Human Rights (PHR) and the Organization for Justice and Accountability in the Horn of Africa (OJAH).
Renewed clashes have been reported between the Ethiopian National Defense Force and regional and ethnic armed groups in the country’s Tigray, Amhara, and Oromia regions. PHR and OJAH are receiving reports that renewed fighting and the risk of further grave violations, including conflict-related sexual and reproductive violence, are driving people to leave the Tigray region in recent days. Health care workers in the Amhara region have reported already seeing impacts of the ongoing fighting in their communities. For example, in November 2025, a drone attack on a health facility in the North Wollo zone in the Amhara region resulted in multiple civilian casualties.
“Reported attacks in Tigray, Amhara, Afar, and Oromia regions, and escalation of threats between Ethiopia and Eritrea, put civilians back in the crosshairs with dire consequences for their health and human rights. The international community allowed serious violations of human rights and international humanitarian law to happen with impunity during the last conflict in northern Ethiopia. We must ensure that this does not happen again,” said Lindsey Green, PHR’s deputy director of research.
In Echoes of Violence, OJAH recorded extensive and widespread atrocities that occurred during the war between the Ethiopian government (with support from Eritrea and regional militias) and the Tigray regional government from November 2020 to November 2022, including mass killings, forced displacement, and attacks on civilians by both Ethiopian and Eritrean forces. In You Will Never Be Able to Give Birth: Conflict-Related Sexual and Reproductive Violence in Ethiopia, PHR and OJAH documented widespread conflict-related sexual and reproductive violence in the Tigray, Amhara, and Afar regions, even following the November 2022 Cessation of Hostilities Agreement, where survivors continue to lack access to essential services, including health care, rehabilitative, and mental health services. They are also routinely deprived of access to justice mechanisms necessary to seek redress for the violence they have experienced.
The ongoing crisis for survivors of these violations and their communities is exacerbated by reports of continued civilian harm, including sexual violence, in the Amhara region, as well as ongoing limitations on transportation, banking, and telecommunications, and restrictions on humanitarian aid halting reconstruction efforts in Tigray. The Ethiopian government also continues to increase restrictions on civil society organizations in advance of the June 2026 national elections. Additional reports of escalating regional tensions between Ethiopia and Eritrea, and of Ethiopia hosting a training camp for the Rapid Support Forces (RSF) paramilitary group from Sudan, all raise concerns about the potential for regional conflict.
“Three years after the Pretoria Agreement on the Cessation of Hostilities, the lack of meaningful dialogue between the conflicting parties, weak engagement of regional and international actors, and insignificant progress made on the adherence to international human rights law and protection of civilians appear to be leading Ethiopia and the broader Horn of Africa down a new path of war. Given the persistent pattern of conflict-related human rights abuses in the region, we are deeply concerned about the impact of another war on the civilian population,” said OJAH’s executive director.
Health professionals scarred by the war and blockade-related shortages from the Tigray conflict told OJAH that they have a persistent fear and an overwhelming sense of helplessness about the prospect of renewed fighting. With limited supplies and no assurance of resupply, they are increasingly forced to withhold non-emergency care to preserve what remains for potential mass casualties should full-scale war resume in northern Ethiopia. The brief interruption of flights to the Tigray region following short clashes late last month serves as a critical reminder of how quickly conflict can disrupt services essential for the well-being of civilians.
As international and regional actors gather for the 39th African Union (AU) Summit in Addis Ababa and the 61st session of the UN Human Rights Council (HRC) in Geneva, they must press Ethiopia and Eritrea to stop the violence. They must also prioritize consistent and transparent human rights monitoring, including regular reporting by the Office of the High Commissioner for Human Rights, and support the reestablishment of an independent investigative mechanism to ensure documentation for future accountability efforts. Most urgently, provision of humanitarian aid and health care must be delivered immediately to affected communities, many of whom have already experienced egregious acts of violence and now risk further grave harm.
Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.