Tigray peace process faces challenges from geopolitical tensions and humanitarian needs

Four years after the November 2022 Pretoria Agreement ended large-scale fighting between the Ethiopian federal government and Tigray regional forces, the region continues to face significant instability and humanitarian challenges. While the agreement remains formally accepted by the Ethiopian government and the Tigray People’s Liberation Front (TPLF), implementation has been selective. Issues such as incomplete disarmament, the presence of non-federal forces, and the failure to return Western Tigray to Tigrayan administration persist.

Geopolitical tensions between Ethiopia and Eritrea regarding access to the Red Sea have further complicated the peace process, turning disputes over territory and political representation into political tools. This phenomenon, described as ‘conflict consolidation,’ sees large-scale war replaced by displacement, political exclusion, and localized fighting.

On the humanitarian front, healthcare services in Tigray remain severely strained. Maiani General Hospital in Sheraro, supported by Médecins Sans Frontières (MSF), serves approximately 250,000 people. The facility provides critical maternity, neonatal, and mental health services, often to patients who must undertake difficult journeys to reach care. Despite the cessation of major hostilities, tens of thousands of people in the region remain displaced with limited access to food, water, and sanitation.