The Ethiopian government and the Tigray People’s Liberation Front (TPLF) signed the Pretoria Agreement three years ago, at least silencing the guns in the Tigray Region following two years of brutal war. It remains on record as one of the world’s deadliest conflicts of the 21st century, with an estimated 600,000 civilians killed in a region occupied by only 6 million people.
But a confluence of factors threatens to reignite the conflict and potentially destabilize the wider region: the Ethiopian government’s failure to fully implement the agreement, a lack of justice and accountability, and a split within Tigray’s leadership, one faction backing the government in Addis Ababa and the other siding with leaders in neighboring Eritrea who had supported Addis during the war. To prevent further deterioration, regional and international actors, including the United States, which played a significant diplomatic role in the deal’s signing, must spotlight the risks in the region, re-engage, impose sanctions on spoilers, and support political dialogue and reconciliation efforts across Ethiopia. Furthermore, to reduce human suffering among the hundreds of thousands of people still displaced in the region, aid providers and donors must scale up humanitarian assistance immediately.
In addition to the death toll over just two years, the 2020-2022 Tigray War also led to the collapse of the region’s healthcare system and the destruction of healthcare facilities. Agriculture and other food-related infrastructure indispensable to the population’s survival were destroyed, inducing acute food shortages and nutritional crises. In some regions, including Tigray, 62 percent of children under 5 are experiencing acute malnutrition, according to a study led by the United Nations, the European Union, and local authorities. An assessment by Tigrayan health researchers found already in the year after the war that “Starvation was the leading cause of death across all ages in the study group.” Local aid workers on the ground have indicated in interviews with our team that deaths due to starvation have increased, as have deaths due to untreated illness and preventable conditions like hypertension and diabetes.
The Pretoria Agreement, signed in November 2022, called for the cessation of hostilities, full humanitarian access, the withdrawal from western Tigray of Eritrean troops and other forces from other regions, and transitional justice. But while active fighting stopped, many of the agreement’s terms remain aspirational. Despite the call for withdrawal of foreign and non-federal forces, large parts of Western, Southern, and Northern Tigray remain under the control of Amhara regional forces and Eritrean troops. These forces continue to perpetrate grave abuses with impunity – sexual violence, arbitrary arrests, abductions, torture, and widespread land seizures.
The Pain of Aid Cuts
Furthermore, Tigray, like other regions in Ethiopia, has felt the pain of aid cuts by major donors, including the United States. Ethiopia had been one of the top recipients of foreign aid from the United States, receiving $1.8 billion in assistance for food, healthcare, education, job assistance, and more in 2023. Most of those programs were halted after the U.S. freeze on foreign aid. Local groups have decried the impact on children with HIV/AIDS who could no longer access their medications.
More than 760,000 people are still internally displaced, unable to return home, rebuild their lives, or even reclaim their lands, in part because one-third of the region is occupied by Eritrean or Amhara forces and the previous residents don’t feel safe returning. A recent study of internally displaced people (IDPs) in Tigray conducted by the Commission of Inquiry on Tigray Genocide, an investigative body established by Tigrayan regional authorities, indicates that some have not received any aid since they were displaced years ago. Others have experienced a suspension of food distribution for months at a time. Those who do receive aid report that the quality is poor, including spoiled maize grain (kernels) or sorghum unfit for consumption.
Children have been out of school for years, with only 40 percent of school-aged children having enrolled in school as of about a year ago. About 2.4 million school-aged children were not attending schools, partly because 88 percent of school infrastructure was damaged. Many displaced families seek shelter in crowded schools that are unsafe and unsanitary, or they sleep in the open air.
Tigray’s women and girls have borne some of the worst scars of the conflict: sexual violence was pervasive, and some have still not received treatment for physical injuries and the psychological toll or have been shunned by their communities. Health groups in Tigray emphasize that many of the survivors continue to need support to cope with the trauma of sexual slavery, gang rape, and other horrifying attacks.
It is not surprising, then, that many IDPs feel abandoned and hopeless. The world rallied behind the Pretoria Agreement as a path to peace and recovery, but failed to sustain pressure on Ethiopia and other actors to uphold it. Donor fatigue and geopolitical distractions have left aid and development in Tigray and Ethiopia’s other regions dangerously underfunded. Without sustained pressure, the Pretoria Agreement risks joining a long list of African peace deals that looked good on paper but collapsed in practice, leaving the most vulnerable to pay the price.
Tigray is not the only Ethiopian region affected by the cuts in humanitarian aid. The Gambella region in western Ethiopia near the South Sudanese border hosts around 40 percent of the country’s refugee population of more than 1 million. Most of those refugees are from South Sudan. Since last year, refugees in some of Gambella’s camps have been surviving on just a fraction of the recommended daily food ration, and now there is a risk that the ration will be reduced further.
Honoring Commitments and Re-Engaging for Peace
A genuine peace in Tigray requires more than declarations; it demands enforcement, justice, and political courage. The Ethiopian government must honor its commitments by ensuring the withdrawal of all non-federal forces, facilitating the safe return of displaced people, and holding perpetrators of abuses accountable. Other actors within Ethiopia, including the Tigrayan leadership and other groups, must avoid escalation and tensions that risk reigniting the tinderbox in the north. Renewed conflict in Tigray, which would likely involve Eritrea, would be catastrophic: long, drawn out, and deadly.
Likewise, international actors like the United States must re-engage – through verification that the parties to the agreement are meeting its terms, by imposing sanctions on spoilers, and by supporting local reconciliation efforts. The United States can press for political dialogue and link its engagement to security and commercial interests. It also should work with partners who were involved in the diplomatic coalition that was instrumental in mediating the Pretoria Agreement, including the African Union, Kenya, and others. Above all, humanitarian assistance must be scaled up immediately to prevent further human suffering. Donor states must increase funding to the United Nations and other relief agencies and organizations, recognizing that lives are being lost every day that funding is not provided.
The people of Tigray have endured enough. The Pretoria Agreement, while imperfect, is the only path to peace at this moment. A return to war is indeed possible, and would be catastrophic for Tigray and neighboring regions in Ethiopia as well as for the wider Horn of Africa. Without decisive action, Ethiopia risks allowing its most important opportunity for peace to slip away.
