More than four years after the crisis broke out in December 2013, the situation in the Central African Republic (CAR) remains extremely serious. Humanitarian needs are on the rise and have reached a level similar to the peak of the crisis in 2013-2014. Fourteen humanitarian workers have been killed so far this year, which makes CAR the most dangerous country in the world for humanitarians after Syria. In November, international aid organisations in some areas in the north suspended their activities and evacuated all their staff.
Some 2.2 million people in the country – almost half of the population – are in need of humanitarian assistance. Around 1.4 million people are food insecure. Chronic malnutrition has increased and is currently among the highest in the world (around 40% of the under 5-year old population according to UNICEF). Communities' stocks are empty and livelihoods have been severely affected by fighting and looting, provoking substantial increases in food prices and a substantial decrease in household income. The situation of the still very high number of internally displaced is of particular concern.
The weak national health system has collapsed due to widespread violence. There is also a severe shortage of skilled health workers and medical supplies. Up to 58% of health infrastructures are supported by humanitarian actors. This lack of access to basic healthcare continues to have serious repercussions for the population. Needs in water, sanitation, and hygiene (WASH) are particularly severe in the areas most affected by the conflict and maintaining an adequate level of WASH remains a challenge, especially in internally displaced person's (IDP) sites. Safe drinking water is scarce.
The crisis has also spilled over into neighbouring countries (in particular in Chad and Cameroon) and the effects are considerable, notably in terms of pressure on local resources.
With over €400 million provided since 2014, the European Union (Commission + Member States) is the largest donor of humanitarian assistance to CAR. The European Commission alone has provided €136 million in humanitarian aid inside the country since December 2013, in addition to over €83 million for Central African refugees in neighbouring countries.
The spill-over over the crisis to neighbouring countries has been significant, with the refugee situation becoming protracted. Humanitarian needs created by the CAR conflict, including in bordering Cameroon and Chad, are therefore considered a forgotten humanitarian crisis by the European Commission.
The Commission's humanitarian assistance primarily targets needs in the areas of food, health, emergency shelter, water, sanitation and protection of civilians. Relief assistance is focused on displaced people both inside and outside IDP camps, as well as on refugees who mostly rely on humanitarian assistance to cover their needs. Support to operations (coordination, air services) is also crucial.
The Commission also funds humanitarian projects to enable free access to primary health care services through mobile clinics, with a main focus on life-saving interventions and the control of epidemic-prone infectious diseases. Projects seeking to improve the protection of civilians are also being supported, including tracking of incidents, medical, psychosocial and legal support to victims, as well as actions offering a protective environment for children.
In 2017, the European Commission has also supported the UN humanitarian air services (UNHAS) in order to facilitate the transport of humanitarian personnel to remote locations which would otherwise remain inaccessible due to insecurity and very poor infrastructure.