Cholera outbreak in April presents an additional concern for food security

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In Yemen, livelihood options and income-earning opportunities remain severely limited following years of protracted conflict and poor economic conditions. With millions of poor households already facing food consumption gaps across the country, a total pause in WFP-provided humanitarian food assistance in areas controlled by the Sana’a-based authorities (SBA) has affected more than 9.5 million people since December 2023. In April, an upsurge in cholera cases has added to concerns for acute food insecurity, as cholera increases households’ essential health expenditure requirements for treatment and may reduce the number of household members able to earn income. The good start to the March to May first rainy season in highland areas and the ongoing mango harvest in Tehama and along the Arabian coast are providing poor households with some opportunities for labor. However, these seasonal improvements are not enough to enable most poor households to meet their basic needs, and across the country, Crisis (IPC Phase 3) and Crisis! (IPC Phase 3!) outcomes remain widespread, with several governorates in SBA areas expected to be facing Emergency (IPC Phase 4) outcomes amid the ongoing pause in assistance.
Economic conflict between the internationally-recognized government (IRG) and the SBA continues to impact financial and monetary systems, posing challenges to business activity and money transfers. In April, the two Central Banks of Yemen (CBY) continued feuding after tensions escalated in March. Subsequent to the developments reported in FEWS NET’s March Key Message Update, the Sana’a-based CBY announced on March 30 that it would replace the damaged 100 YER currency notes currently in circulation with new 100 YER coins. The CBY-Aden rejected this move, ordering IRG-based banks to refuse to deal with the coins.
Shortly after the CBY-Sana’a announced intentions to circulate 100 YER coins, the CBY-Aden also ordered all commercial, Islamic, and microfinance banks to relocate their headquarters to Aden within 60 days, with strict measures to be taken against banks that do not comply (such as freezing accounts of non-compliant banks or disconnecting them from the international SWIFT system). To date, there have been no notable impacts of these developments on local currency exchange rates. It remains to be seen whether banks will comply, as relocating will be difficult and will risk retaliatory actions by the SBA. Should these banks relocate, however, IRG areas would be expected to experience an increase in liquidity while SBA areas would in turn likely face worsening liquidity shortages, with negative impacts on small businesses. Additionally, further retaliatory action by either side could disrupt money transfers—including remittances—between IRG and SBA areas.
Incidence of suspected cholera cases has increased sharply in April. According to the Ministry of Public Health and Population’s Integrated Disease Early Warning System, around 2,458 suspected cases of cholera were recorded from January 1 to April 21, 2024 (13 percent of which were confirmed), with Lahij and Aden recording the highest totals. The total in April was more than 50 percent higher than the 1,642 suspected cases recorded during October to December 2023 (7 percent of which were confirmed). In the week of April 21, incidence peaked at 1,049 suspected cases, much higher than the peak incidence recorded in the previous outbreak of late 2023 but still below the peak of the 2019 outbreak. While official data are not collected in SBA areas, available reports and information suggest that conditions are more severe. As of April 7, more than 11,000 suspected cases and 75 associated deaths have been reported since October 2023, compared to about 3,200 suspected cases reported in IRG areas where response efforts and treatment options are stronger. Risk of cholera is especially high among IDPs who live in crowded conditions with poor hygiene facilities. Most of those affected by cholera nationwide are children under five, increasing the risk that acute malnutrition will worsen among them.
In early April, hostilities intensified in the frontline areas of western Al Dhale’e and on the Ta’izz-Lahij border, though this is assessed to be within typical patterns of volatility and temporary upticks in conflict in the post-truce period. Overall, levels of conflict in Yemen remain low compared to the pre-truce period (before April 2022) and even lower compared to the previous year. It should be noted, however, that the intermittent conflict still impacts civilians in frontline areas by causing casualties and displacement, limiting livelihood activities, and causing fresh losses to households who have sought to re-invest in livelihoods. Between January 1 and April 27, the IOM displacement database tracker reported 1,067 newly displaced households in monitored IRG areas. This is 65 percent lower than the number displaced in the same time period of 2023 and 79 percent lower than during the pre-truce period (January 1 to April 2, 2022).
Following flooding that occurred in March, intense rainfall in late April caused further flooding in several areas, with Hadhramaut, Al Mahrah and Shabwah among the most affected. The heavy rains and flooding disrupted livelihoods, destroyed IDP shelters, damaged water sources, roads, and infrastructure, and caused loss of life and assets in the area. According to local reports, there were 12 deaths due to flooding, and more than 3,000 IDPs were impacted. Many affected areas in Hadhramaut and Al Maharah were also impacted by flooding linked to cyclone Tej in October 2023 and, while the recent flooding was not as severe, the cumulative impacts on livelihoods and household coping capacity are of concern. The IRG has called for the support from the international community, donors, and financial institutions to aid in the response.
On April 24, the SBA resumed attacks in the Red Sea and Gulf of Aden, following a lull in attacks since April 13. While the frequency and intensity of attacks remain lower than when the SBA began attacking ships in these waters in November 2023, the tensions in the Red Sea have limited income-earning opportunities for thousands of Yemeni households who depend on fishing and associated supply and marketing chains. Meanwhile, the presence of landmines also continues to harm civilians and limit the recovery of livelihoods in the post-truce period, particularly for livestock breeders. In March, landmines and unexploded ordnance (UXO) were responsible for 16 civilian casualties, including five fatalities, representing around a 50 percent decrease since February. This decline is likely at least partially attributable to seasonally limited livestock grazing. However, risk is expected to increase as the March to May rains replenish pasture as well as wash landmines from contaminated sites into residential and agricultural areas. As part of ongoing demining efforts, the King Salman Humanitarian Aid and relief Center (MASAM) removed around 2,374 landmines and UXO from Aden, Al Hudaydah, Al Jawf, Marib, and Shabwah in March, while demining efforts in SBA areas remain more limited.

Recommended citation: FEWS NET. Yemen Key Message Update April 2024: Cholera outbreak in April presents an additional concern for food security, 2024.

This Key Message Update provides a high-level analysis of current acute food insecurity conditions and any changes to FEWS NET's latest projection of acute food insecurity outcomes in the specified geography. Learn more here.