Climate variability and human health risks in Ethiopia 2000 to 2025 systematic review of vector borne diseases and extreme weather events

Climate variability has significant implications for human health in Ethiopia, particularly through the increasing risks of vector-borne diseases and extreme weather events. This systematic review synthesizes national-scale evidence on the effects of climate variability on human health in Ethiopia between 2000 and 2025, with particular emphasis on malaria, cholera, Rift Valley fever, droughts, floods, and heat-related risks. Following PRISMA guidelines, a systematic search was conducted using PubMed, Scopus, Web of Science, Google Scholar, and gray literature sources. Search terms included “climate variability,” “human health,” “vector-borne diseases,” “extreme weather events,” “malaria,” “cholera,” and “Ethiopia.” Only English- and Amharic-language studies published between 2000 and 2025 were included because these languages represent the most accessible and policy-relevant scientific evidence in Ethiopia during the selected review period, while duplicate, irrelevant, and non-empirical studies were excluded. Findings indicate that Ethiopia has experienced substantial climatic variability since 1960, with mean annual temperatures increasing by approximately 0.2–0.5 °C per decade and minimum temperatures rising faster than maximum temperatures. This trend has intensified nocturnal heat stress and contributed to the expansion of malaria transmission into highland areas. Rainfall variability remains highly heterogeneous across the country, with relatively stable conditions in the western highlands but strong fluctuations in northern, central, and lowland regions, where seasonal coefficients of variation frequently exceed 40–60%. These climatic changes have increased the frequency and severity of droughts and floods. Health impacts were identified under four major themes. First, vector-borne diseases such as malaria and Rift Valley fever have expanded due to rising temperatures and changing rainfall patterns. Second, waterborne diseases, particularly cholera and diarrheal infections, have increased during flood and rainfall extremes. Third, recurrent droughts have intensified food insecurity and malnutrition in vulnerable communities. Fourth, increasing temperatures and heat waves have elevated heat-related health risks, especially in urban areas. The review highlights urgent adaptation priorities, including integrating climate data into health surveillance and early warning systems, strengthening malaria and vector-control programs in highland fringes, improving water, sanitation, and hygiene (WASH) interventions, and enhancing resilience to droughts, floods, and heat stress. The findings demonstrate that climate variability is increasingly driving the risks of vector-borne diseases and extreme weather-related health impacts in Ethiopia, emphasizing the need for integrated and climate-responsive public health strategies.