Study finds country-local sources accounted for only 4.9 percent of ChatGPT citations on Ethiopia-related questions

Ethiopian institutions and media organisations remain largely invisible in generative artificial-intelligence answers about the country’s humanitarian crises, according to a new study examining how AI platforms select and cite evidence.

The study, Citation Localisation in Generative AI Answers: Whose Evidence Is Visible in African Humanitarian Crises?, analysed answers generated by Gemini, DeepSeek, ChatGPT and Perplexity in response to humanitarian questions covering 10 African countries, including Ethiopia.

In a complete 90-question ChatGPT analysis, country-local sources accounted for 7.2 percent of all citations. However, the share for Ethiopia was lower: local Ethiopian sources provided four of 81 citations, equivalent to 4.9 percent.

The findings raise questions about whose knowledge becomes visible when journalists, policymakers, donors, researchers and members of the public use AI systems to understand humanitarian conditions in Ethiopia.

The study’s broader cross-platform sample found that country-local producers supplied 5.5 percent of 1,083 answer-linked citations, while African-based organisations accounted for 6.6 percent. UN and multilateral organisations dominated the citation landscape, providing 68.8 percent of the citations.

The complete ChatGPT analysis showed a similar pattern, with UN and multilateral organisations accounting for 70.9 percent of citations.

The study found that AI-generated humanitarian answers typically rely on a small group of major international institutions. Across the full citation corpus, UNICEF received 136 citations, followed by UNHCR with 100, OCHA and Humanitarian Country Team products with 73, OCHA with 64 and IOM with 63.

The five most-cited producers accounted for 40.3 percent of all answer-linked citations, while the top 10 accounted for 58.8 percent.

For Ethiopia, this means that information from international organisations is more likely to appear in AI-generated responses than evidence produced by national ministries, local humanitarian organisations, Ethiopian research institutions or domestic media outlets.

The study cautions that the results do not prove that AI systems are intentionally biased against Ethiopian sources. It also does not claim that local evidence was unavailable. Instead, it measures what sources were visibly cited under a standardised research protocol.

A formal measure of under-citation would require a complete list of all relevant, available and retrievable Ethiopian sources for each question, the study said.

The research found that local sources rarely replaced international sources entirely. Instead, they generally appeared alongside UN or multilateral evidence.

Of the 186 cited observations in the recoverable cross-platform sample, 33 included at least one country-local source. Twenty-eight of those 33 responses—84.8 percent—also cited a UN or multilateral organisation.

Only one response relied exclusively on country-local sources.

The pattern was similar in the ChatGPT analysis. Local-citing answers contained a lower average share of UN citations than responses without local sources, suggesting that local evidence can diversify the information presented by AI systems even when international organisations remain central.

For Ethiopia, the inclusion of local sources could provide additional context on displacement, conflict, food insecurity, humanitarian access, public services and the work of national and community-based responders.

The study points to several reasons why Ethiopian sources may struggle to appear in AI-generated answers.

International organisations often have dedicated information-management teams, stable websites, standardised publication formats, clear metadata and global syndication networks. Ethiopian institutions and local organisations may possess detailed field knowledge but publish less frequently, use less searchable formats or distribute information through channels that AI systems retrieve less consistently.

Language is another factor. All questions in the study were submitted in English. This may favour Ethiopian organisations that publish in English while disadvantaging authoritative material available mainly in Amharic or other Ethiopian languages.

The study also found that intermediary platforms played a significant role in how humanitarian evidence became visible. ReliefWeb hosted 217 of the answer-linked citations, accounting for 20 percent of the entire corpus and 93.9 percent of intermediary-hosted citations.

A domain-only analysis could therefore incorrectly identify ReliefWeb as the original producer of information created by OCHA, UN agencies, Ethiopian institutions, NGOs or other humanitarian actors.

The findings suggest that Ethiopian humanitarian organisations need to invest not only in collecting information, but also in making that information discoverable and attributable.

The study recommends publishing evidence through durable web addresses, accessible HTML pages, consistent organisational names, clear dates, identifiable authorship and machine-readable formats. Such measures could help AI systems and other digital platforms retrieve and attribute Ethiopian evidence more accurately.

International organisations and repositories also have a role to play. When reports are produced with Ethiopian partners or based on data collected by national institutions, metadata and publication pages should clearly preserve the original contributors’ identity.

Africa’s next major economic-integration gains will come not simply from lowering tariffs, but from connecting production, services, infrastructure and financial systems across borders, according to a new World Bank report launched in Addis Ababa.

The report, Integrating Africa: From Threads to Hubs, calls for African governments to turn continental commitments, including the African Continental Free Trade Area (AfCFTA), into functioning regional markets and production hubs. It argues that firms must be able to source inputs, manufacture products, obtain finance and sell across borders under predictable and interoperable rules.

Launched at an event co-hosted by the African Union Commission, the United Nations Economic Commission for Africa and the World Bank Group, the report says Africa’s integration agenda should focus on practical reforms that reduce trade costs and make regional value chains commercially viable.

“Africa has a continental free trade agreement. The focus is now implementation,” said Ndiamé Diop, World Bank Vice President for Eastern and Southern Africa. “We are working with the AfCFTA Secretariat, other African institutions, governments, and the private sector to connect 54 economies into an integrated continental market of 1.5 billion people, with regional production hubs that can attract investment and create jobs at scale.”

The World Bank estimates that deeper liberalisation of transport, telecommunications, financial and professional services could increase trade in services within the AfCFTA area by about 60–64 percent by 2035. Such reforms would also support stronger intra-African trade, create better jobs and help countries develop more diversified regional value chains.

Intra-regional trade currently accounts for roughly one-fifth of Sub-Saharan Africa’s exports. The report notes that trade within Africa is generally more diversified and more manufacturing-intensive than exports to global markets, which remain heavily concentrated in raw commodities.

The report argues that regional integration is therefore not only a trade-policy objective but also a structural requirement for industrialisation. It says that individual national markets often lack the scale needed to support competitive manufacturing, while regional markets can widen the range of viable industrial activities and investment opportunities.

Domestic Barriers Remain the Main Challenge

According to the report, approximately 60 percent of Africa’s estimated trade costs are unilateral or “behind-the-border” barriers within countries’ control. These include customs delays, inefficient logistics, transport restrictions, fragmented standards, barriers to services and weak infrastructure.

The finding suggests that governments can secure significant integration gains through domestic reforms without waiting for additional regional negotiations. The World Bank recommends electronic single-window systems, risk-based inspections, more competitive freight markets, simplified rules of origin, stronger standards institutions and more open transport, financial and professional services.

The report places particular emphasis on interoperability—the ability of goods, data, payments, finance and regulatory systems to function smoothly across national borders. It argues that market liberalisation on its own will not be sufficient if firms continue to face incompatible customs procedures, payment systems, transport rules and technical standards.

The World Bank sets out four interconnected priorities: building regional value chains that link production across borders; reducing trade and regulatory frictions; deepening, implementing and enforcing regional trade agreements; and providing regional public goods, including transport corridors, power markets, digital networks and payment systems.

The report also calls for stronger enforcement of AfCFTA commitments, including more credible dispute-settlement arrangements, deeper services and investment provisions, and flexible coalitions of countries able to move faster where broad continental consensus is difficult to achieve.

African Union Commission Deputy Chairperson Selma Malika Haddadi said the agenda requires cooperation among continental institutions, governments, regional economic communities and businesses.

“No institution can deliver Africa’s integration agenda alone,” Haddadi said. “The African Union Commission, UNECA, the World Bank Group, Member States, regional economic communities, and the private sector must work together to translate continental frameworks into practical investments and reforms that make regional integration work for businesses and citizens.”

Rather than judging integration by the number of agreements signed, the report says progress should be measured through outcomes that affect firms and citizens directly. These include shorter border-crossing times, lower logistics costs, more reliable infrastructure, greater recognition of professional qualifications and standards, the resolution of non-tariff barriers, more private investment and wider participation in regional value chains.

The report comes as African economies face a changing global trading environment, including increased fragmentation, erosion of preferential market access and shifts in global value chains. It argues that stronger regional production networks could help African countries build resilience, reduce dependence on commodity exports and capture more value from manufacturing and services.

In East Africa, limited access to emergency medical services remains a significant public health challenge. Recent data reveals that over half of Ethiopia’s population lives more than a two-hour journey from surgical centers.

This substantial geographical barrier is exacerbated by severe infrastructure shortages. For instance, approximately 51 percent of all intensive care unit (ICU) beds and specialist physicians are concentrated solely in the capital city. During a recent discussion on surgical safety, public health leaders, policymakers, and international experts emphasized that urgent medical and surgical interventions are not luxuries but fundamental components of universal health coverage (UHC) and national health security.

Emergency, critical, and operative (ECO) care provides continuous, essential services for patients experiencing acute conditions, from severe postpartum hemorrhage and trauma to acute sepsis in children. While traditionally fragmented across different health sectors, modern public health frameworks now integrate ECO care into a single, unified patient pathway. Dr. Bejoy Nambiar, Health Systems and Policy Advisor at WHO Ethiopia, noted, “Patients do not experience health systems through institutional and fragmented boundaries.” A mother with severe postpartum hemorrhage, for example, requires an unbroken clinical pathway: rapid identification, emergency transport, resuscitation, blood, a skilled anesthesia provider, and surgery.

Timely interventions at primary and district health facilities offer high economic returns. They prevent easily treatable conditions from escalating into expensive tertiary-level care, thereby protecting vulnerable families from catastrophic out-of-pocket costs and bankruptcy.

As Dr. Nambiar highlighted, ECO care is “an essential fiscal policy that shields families from bankruptcy, keeps breadwinners alive, and protects national economic productivity.”

Recognizing this critical need, international health milestones such as World Health Assembly Resolution 72.3 and the broader global strategy for integrated ECO care urge member states to directly incorporate emergency medical care into national policies. Implementing these frameworks ensures that health systems can reliably detect, stabilize, manage, and respond effectively to both everyday emergencies and large-scale public health crises.

A recent discussion, which included representatives from international health organizations, the Africa CDC, the World Health Organization (WHO), and the Ethiopian Ministry of Health, underscored the wide disparities in basic surgical readiness across low- and middle-income countries.

A key issue central to the discussion was the shortage of capnography, a vital monitoring technology used by anesthetists to prevent catastrophic complications during surgery. According to expert data, one in three operating rooms worldwide lacks any capnography service. Furthermore, preliminary studies in Somalia and other regions indicate that over 65 percent of surgical procedures are performed in facilities without basic equipment.

Ethiopia has a long history of leadership in planning surgical and emergency care within the region. In 2016, years before international frameworks were adopted, the country launched the Saving Lives Through Safe Surgery (SaLTS) roadmap, a pioneering, comprehensive national plan for surgery, obstetric, and anesthesia services. This sustained institutional focus on emergency care has led to emergency medicine becoming an established medical specialty, supported by residency training hubs and dedicated crisis/outbreak response teams.

To bridge rural service delivery gaps and address specialist physician shortages, Ethiopia’s health strategy incorporates four key structural shifts, as outlined by health authorities such as expanding specialist training and integrating digital dispatch and monitoring tools.

Despite these significant structural advancements, considerable operational vulnerabilities persist. Critical shortages in both workforce and materials remain; the country has approximately 0.3 ICU beds and 0.5 surgical, obstetric, and anesthesia physicians per 100,000 population. Furthermore, the majority of citizens requiring essential surgeries still face substantial financial burdens, underscoring that surgical safety is fundamentally a broader health system challenge.

Organizations like Lifebox are actively distributing specialized equipment to frontline facilities, collaborating with the Ministry of Health, professional societies, and academic institutions.

Senait Bitew, Chief Program Officer at Lifebox, explained that the organization was founded “to close the implementation gap studied around surgery and surgical anesthesia safety, and to put safe surgical systems, tools, training, and monitoring into the hands of individual surgical teams where the need is greatest.”

A primary focus of these initiatives is the expansion of capnography, a clinically proven vital monitoring technology crucial for preventing intraoperative deaths during anesthesia. Preliminary findings from studies conducted by Lifebox and its partners reveal striking realities: “One in three operating rooms worldwide has no capnography capability at all,” and regional facility assessments indicate that a high volume of surgical units lack complete equipment readiness. Bitew emphasized that resolving these deficits requires strong ecosystem collaboration, noting that “no single organization or technology can close this gap alone. It takes an ecosystem, and the Ministry of Health sits at the center of this partnership.” To move away from short-term philanthropic dependence, leaders are advocating for structural change. Senait urged stakeholders to “fund these procurements through national budgets,” adding, “otherwise, we cannot always depend on philanthropy.”