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Figure from:State of addis ababa-compressed

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Source: AAWSA, November 2020 — Table 4 Source: AAWSA, November 2020

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well-being of the city’s residents during the ongoing pandemic, and in the future, should disease outbreaks occur.

mm Urban form, structure and function and their role in the spread of COVID-19: The literature

Figure 1.1: Urban structure concept and current land use according to Addis Ababa’s 10th structure plan

Source: Authors Table 1.2: Urban spatial pattern distribution of Addis Ababa in 2020

Source: Maxar Satellite Images. 1 January 2020; Authors Figure 1.2: Urban spatial pattern classification map of Addis Ababa

Source: Authors Table 1.3: Urban spatial pattern in the 10 sub-cities of Addis Ababa

attenuate the spread of the disease, have hit

Table 2.2: Evolution of water supply 2017-2020 system relies on foreign currency availability fuel and spare parts), which made this (for type finan of water product ion very challenging cially (AAWSA® , 2020). Consequently, the yearly growth of th tion e city water produc- is 6-7% (see Table 2.2) which can barely keep up with the annual population growth and faile tr addrace tha avictinn hacking to be at the center of addressing urban health challenges and therefore the implementation of such projects is critical if urban health is to improve sianificantly in Addis Ababa.

improvement, however, the gap between sup- ply and demand remains huge. This is partic- ularly true in Addis Ababa, the economic hub of the country.

Table 2.5: City-level parks in Addis Ababa in 2020

Source: Computed based on data obtained from AARBGADAA, December 2020* ; CSA, 2013%**

on inequalities in the city. Safe, easily ac-

Source: Addis Ababa Youth and Sport Commission, June 2018

Source: Addis Ababa Youth and Sport Commission, June 2018 Table 2.8: Sport facilities in Addis Ababa by ownership status As per the situational assessment re- port of Addis Ababa Youth and Sport Com- mission (AAYSC, 2018), there are 185 sports facilities accessible by city res- idents while an important share of the availahla farilitiac ara not — flinctingnal

minutes (AACPSO, 2021). The average wait- ing time on the Light Rail Transit (LRT) is 12 minutes on the green (E-W) line and 15 min- utes on the blue line (N-S) (AATA 2016). Public transport is over-crowded, infre- quent, and service delivery is fragmented. Due to poor route design and limited in- ter-operability, very often, several transfers are needed in order to reach a destination. The average single journey for a minibus taxi is 6.9 km and for a bus is 14.5 km. The aver- age waiting period until the special COVID-19 measures were introduced was around 60 2.) Transport and mobility t is estimated that around 4 million trips are generated in the city daily (Asgedom, 2013). Of those trips, 54% are estimated to be non-motorized movements and 46% are motorized movements (31% public transport users and 15% of private vehicle users). By the and of Jily JNI0N which ie the and of the also major potential sources of COVID-19 Public transport is over-crowded, infre- to play on the road which makes them ex- fiscal year, there were approximately 1.2 mil- lion vehicles registered in Ethiopia. Around 50% of these were registered in Addis Ababa, (Abiy, 2020)

About 10,000 mini-bus taxis operate in the city of Addis Ababa. Each has a seating ca- pacity of 12 passengers. These mini-bus tax- is operate on 105 routes and carry more than 2,000,000 passengers per day. On average, a mini-bus taxi covers about 138 km daily and makes 15 trips. Most of the passengers be- In Addis Ababa, at present, the predomi- nantly available modes of public transpor- tation are Light Rail Transit (LRT), city bus, taxi (mini-bus), taxi (Saloon type), and midi buses. The following table shows the differ- ent modes of public transportation in the city buses. The following table shows the differ-

did not last long. In contrast, public trans- port has to carry passengers up to the le- gal capacity (seat capacity) and passengers still have to wear a mask while on-board. Pandemic-related measures in transportation

the inner city. living in such areas, usually of low income,

the only establishments that were allowed to ‘re-open’ and to provide their services during the state of emergency. The pandemic has revealed the importance of the ancient de- sign principles of such places which can be useful design examples in cities that want to anhanra racijilianra Aitringn a nandamin

Figure 3.2: Revenue structure trends 2014- 2019 Unlike many other cities, Addis Ababa h as a right to raise its own taxes and utilize the receipts without remitting to the GoE. It h as a full jurisdiction on revenue and expenditure in the city. The GoE has allocated more th an 1 billion ETB for pandemic emergency mea- enrae Thie amoniint would otharwica hava

been invested on other productive activities. In spite of that support by the GoE, the city expects to run a budget deficit for the first Economic impact of COVID-19 The pandemic has also been affecting Ethiopian cities through its effect on produc- Hon and consumption of goods and services.

Figure 3.4: Percentage of small businesses which reported worse sales than the year be- fore, by sector Economic impact on households and on individuals hat restrictions have affected the service in ni di Residents in informal settlements and mM ums of Addis Ababa, live on precarious comes with little or no connection to run- ng water and poor sanitati overcrowded living condition on. In addition, s have made it fficult to uphold the two-meter separation rule in slums and informal settlements which akes it difficult to contain the pandemic. sector more than the manufacturing sector. The construction sector has been a major

- the formally employed. The following figure 1 illustrates COVID-19’s impact on the low 1 skilled workforce by sector. safeguard the poor in times of such crises. putting informal settlers in unprecedented social insecurity. There is thus a clear need to strengthen social safety nets that would safeauard the poor in times of such crises.

Figure 3.6: Change in average monthly in- comes (Feb-Aug 2020) riod. Formally employed workers have seen ‘&

the total employment in 2019 (WTTC, 2020b).

Table 3.1: Trends in tourist arrivals to Ethiopia: A comparison between 2019 and 2020

Figure 3.7: Ethiopia COVID-19 response time line and events 2021, the dally positivity rate was steadi- ly over 20%. This is well above the 4% WHO threshold, but this is partly due to how the arguably limited testing is targeted. There is no mandatory testing in Ethiopia and there- fore only suspected cases are tested. The positivity rate comes from tests targeting suspected cases and from persons identi- fied through contact tracing. Addis Ababa amounted to 50.41% of the total tests and 62% of positivity cases in the country at the end of February 2021.

In Addis Ababa there are 43 treatment, iso- lation and testing centers, that were part of the COVID-19 treatment process. Hospitals, health centers, event arenas and schools were used as treatment centers at the time. In December 2020, just before the January spike however, 19 centers had been closed, 1,463 beds were no longer in use in treatment centers and 51 beds were not needed in iso- lation centers. According to the MoH (2020), in Addis Ababa all hospitals should operate an agreed rotation system and especially hospitals with more expertise and experience should deploy the necessary number and mix of physicians to the designated treatment center.

of an epidemic that occurs over a wide re-

support mechanisms which benefit vulner-

system and there is anecdotal evidence that effect on the effectiveness of the health care

ed that because of the pandemic, 10.9 mil- 15.2% of the urban population would be at

Figure 4.1: Agencies involved in managing the public health emergency

Interviewee RO9 confirmed that the main responsibility of the Addis Ababa Health Bureau (and its equivalents at low- er governance levels) was contact tracing, screening and monitoring infected peo- ple. Interviewee R10 confirmed that re- ducing economic impact and especially supporting and protecting vulnerable pop- ulations both economically and_health- wise, were at the heart of AACA’s strategy.

Vulnerability can vary depending on the issue that is tackled, and the criteria set. Vul- nerability means being at risk of poverty or social exclusion because of physical disabil- ities, age factors, ethnic origins and/or lack of housing. Vulnerable groups are also those who have traditionally been victims of vio- lence and consequently require special pro- tection (IHRC, 2020).

Table 4.2: Resource mobilization and distribution during COVID-19 by selectec organizations and institutions Source: MoWCY, 2020; AACA,2020; BSC,2020; Interviewee R10, 2020; CSA, 2013; AACA integrated land information center; Addis Ababa City Atlas, 2015; AACA integrated land information center — Bole sub- city Atlas, 2014

Source: AACA, 2020; AACA integrated land information center; Addis Ababa City Atlas, 2015; CSA, 2013.

Source: MoWCY, 2020; AACA, 2020; Bole Sub-City, 2020; Interviewee R10 The Urban Productive Safety Net Program (UPSNP) is the main social welfare benefits program that the Ethiopian federal state op- erates. It amounts to USD 450 million annu- ally of which, USD 350 million is funded by the World Bank. It supports low-income fam- ilies and vulnerable people in 11 major cities including Addis Ababa and had 8 million ben- eficiaries for the period 2016 to 2021 (Born- stein, 2019). The UPSNP and its sub-compo- nents (Temporary Direct Support-TDS and Public Works) are social protection programs designed to enhance inclusive growth and development in urban areas by reducing pov- erty and vulnerability among the urban poor living below the poverty line (AABoFED, 2020).

Sources: *CSA, 2013; **UN-Habitat estimate based on Addis Ababa master plan projections Table 5.1: Nominal density of Addis Ababa in 2020

Figure 5.1: Population density map of Addis Ababa based on CSA 2013 total area. It also has the highest percentage of unplanned urban fabric in the city, which accounts for approximately 86% of its area (see Table 1.3). Currently in Addis Ketema, business buildings are going up on a plot- by-plot basis, which may not necessarily in- crease the resident population but is already affecting the built form and will definitely in- crease the number of people using the area

Figure 5.2: Location of condominium neighbourhoods in Addis Ababa in 2015

Due to the tropical and sub-tropical cli- mate of the country and the lack of reliable

Figure 5.3: Marketplace size, distribution and population density in Addis Ababa

Source: Image © 2021 Maxar Technologies Google Earth

Source: Image © 2021 Maxar Technologies Google Earth

sity and socio-economic characteristics. Even though the findings are in some ways incon- clusive, they clearly highlight the need for any mitigation action to be informed by a solid un- derstanding of the spatiality of the pandemic. This solid understanding translates into ac- curate spatial-demographic statistics about gels = jee A ee es ee ee ee ee BM 2 a A eee ee, See ee ornare 5.3 Measuring the spread of COVID-19

Figure 5.6: Monthly COVID-19 cases May 2020 to February 2021 (positive test results) The pandemics progression in time The spike in August shows the link be- tween the number of tests and the number of cases identified. August was set as a cam- paign month by the Prime Minister’s Office and the Ministry of Health. As soon as the campaign was over in September, the num- ber of cases went down by nearly 50%. Cases dropped again in October and rose slightly in November. Case numbers continued to grow slowly until January, but in February there was another sharp peak.

Table 5.2 Monthly Tests and Positivity rate jor roads. As a result, sub-cities are very dis- similar in population size, area and available resources. However, because testing numbers fluc- tuate, in order to make any claims about the course of the pandemic, it is important to refer to the positivity rate (% of positive tests) and to bear in mind the biases inherent in the Je

Figure 5.7: Spatio-temporal evolution of COVID-19 cases more cases than Kolfe Keranio which had the cember 2020 to February 2021. Kolfe K second highest number of cases. nio had the second highest recorded num 2 cember 2020 to February 2021. Kolfe Kera- nio had the second highest recorded number of cases throughout the period of analysis.

Table 5.3: Monthly number of cases by sub-city (green= lowest, red=highest)

Table 5.4: Spatio-temporal COVID-19 distribution per 100,000 people

Table 5.5: COVID-19 comparison matrix as of 28 February 2021 The map sequence below (Figure 5.8) shows how the pandemic started off from the urban core and quickly moved to the periph- ery of the city, mainly affecting Bole. Table 5.5 shows that except for Bole, there estimated). The sub-city area size seems to seems to be a 1-to-1 correspondence be- be unrelated to the total number of cases.

Figure 5.8: Addis Ababa COVID-19 Prevalence Progression (May 2020-Feb 2021)

The peculiarities of the infection data available

igure 5.11: COVID-19 Prevalence by Woreda from March 2020 to February 2021 Topologically, the Woreda distribution of SOVID-19 is also inconclusive insofar as ointing out a few main sources of COVID-19 yonaqation Explanation/Hypothesis 2: No testing bias.

Figure 5.12 Urban Form and COVID-19 prevalence by Woreda from March 2020 to February 2021

Given the z-score of 1.85436203556, there is a less than 10% likelihood that this clustered pattern could be the result of random chance. Figure 5.13: Spatial Auto-correlation Report from March 2020 to February 2021

22 Given a set of weighted features, hotspot analysis identifies statistically signif- icant hot spots and cold spots using the Getis-Ord Gi* Statistics. It is a test for randomness which identifies significant clusters of high and low values. ‘igure 5.14: Hotspots and cold spots in Addis Ababa from March 2020 to February 2021

Source: AACA integrated land information center, 2015 - Addis Ababa City Atlas. Figure 5.15: Spatial distribution of Hospitals and Health centers by sub-city

Source: Addis Ababa Health Bureau, 2020; Authors

Figure 6.1: Social determinants of health

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