The Lancet <http://www.thelancet.com/lancet/User/vol350no9094> reports that ENSO has killed more than 2,500 people and displaced 1.5 million others in the Horn of Africa with flooding destroying infrastructure and croplands. Ethiopian coffee production will be down 20 %. The U.N. World Food Program and Medecins Sans Frontieres has airlifted food and medical supplies to more than 300,000 people in north-eastern Kenya since mid December. Another 120,000 Somali refugees in the area are also at risk. Diorrhea and malaria are increasing. In Ethiopia, 500 people have died and a quarter million have been forced from their homes. In Uganda, 100 are dead and 60,000 displaced as the Nile flooded.-- Luiz Jacintho da Silva <luisjs@correionet.com.br> in ProMED <promed@usa.healthnet.org>