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Sub-Saharan Africa is the area primarily encompassing countries south of the Sahara desert. This area has seen some of the largest international disaster relief operations in modern times, with relief activities continuously being undertaken in some part of the Sub-Saharan region during the past five decades. As a result of underdeveloped disaster management, healthcare, and agricultural production systems, combined with internal conflicts, the region has become more vulnerable to disasters.

Disasters in the sub-Saharan region have included drought, leading to food shortages in countries such as Somalia, Ethiopia, and southern Africa 2000–03; diseases such as human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS),

Cholera, Malaria, and Tuberculosis; flooding in Mozambique in 1999; plagues of locusts in the Sahel region in Mauritania, Mali, and Niger; internal political conflicts such as in Darfur in Sudan; and ethnic and cross-border political conflicts such as in Rwanda in 1994. Practically the only disaster situations in which sub-Saharan Africa has largely escaped, for geographical reasons, are earthquakes, volcanoes, and tornadoes.

Ethiopia has a long history of disasters. Ethiopia's drought and famine of 1984 and 1985, when an estimated 1 million people died, was one of the most notable disasters in Africa. The Live Aid campaign in 1985 was one of a range of Western initiatives organized with the sole purpose of providing famine disaster relief to Ethiopia. As a direct response to its long history of disasters, Ethiopia has undertaken certain initiatives, such as the establishment of the Relief and Rehabilitation Commission (RRC) in 1973, and the ratification of The National Policy on Disaster Prevention and Management (NPDPM) in 1993. Most recently, joint initiatives by development agencies and the government of Ethiopia have focused on addressing some of the underlying causes of disasters, including capacity building and vulnerability in high-risk areas.

Zimbabwe presents an interesting case for the understanding of relief in southern Africa. Until the 1980s, Zimbabwe was considered a food basket of southern Africa, enjoying a level of food self-sufficiency rarely seen in this region. However, drought in the early 21st century, coupled with inefficient, politically driven land reforms had a major impact on the country's economy. Against this complex set of circumstances, Zimbabwe entered the 21st century heavily dependent on external food relief channeled through humanitarian agencies and multilateral institutions. With the Zimbabwe government under Robert Mugabe holding a firm grip on power, international aid agencies face severe restrictions on operating in that country. Humanitarian agencies and nongovernmental organizations have largely gained access by refraining from political assertions.

The Scourge of Disease

The sub-Saharan African story of disasters includes the plight of malaria and tuberculosis, which have ravaged the continent for decades, as well as the problem of HIV/AIDS, which began in the mid-1980s. Almost every country in sub-Saharan Africa registered alarmingly high levels of HIV infection in the late 1980s and 1990s, with southern Africa and Uganda registering some of the highest infection rates in the world. Most countries in the region had infection rates of between 10–25 percent. HIV/AIDS prevention philosophies and strategies became an international issue, with critics dismissing the initial attitude of South African political leadership and churches relative to HIV/AIDS. The Catholic Church's strategy of abstinence and insistence on the institution of marriage as the basis for combating HIV/AIDS infections in Africa was met with widespread international condemnation.

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