The United States suspended all food aid to Ethiopia on Thursday, citing “widespread and coordinated” theft of the contributions in a country where at least 20 million people need donated food.

The United States is by far the largest aid donor to Ethiopia, with 120 million people, Africa’s second most populous country, so the impact of the suspension is likely to hit hard and fast.

Ethiopians are already reeling from the combined impact of civil conflicts, climate change and swarms of locusts that devoured crops. The United States gave $1.5 billion in aid to Ethiopia, more than two-thirds of that in food, in the last fiscal year, which ended in September, 2022. But American officials said the scale of misappropriation left them with no option but to halt the deliveries until the system had been fixed.

“We made the difficult but necessary decision that we cannot move forward with distribution of food assistance until reforms are in place,” the U.S. Agency for International Development said in a statement. “Our intention is to immediately resume food assistance once we are confident in the integrity of delivery systems.”

The statement did not say who stole the food. But a briefing document by the Humanitarian and Resilience Donor Group, a group of foreign donors including USAID, blamed Ethiopian “federal and regional government entities” it said had diverted the food to “military units across the country.”

The decision comes against a backdrop of tense relations between the United States and Ethiopia, once a key American partner. Two years of civil war in the northern Tigray region between forces of the federal government and regional leaders, which ended with a settlement announced last November, resulted in hundreds of thousands of deaths and accusations of abuses by all sides.

Rights groups and Western officials accused Ethiopian forces of ethnic cleansing, mass rape and using food as a weapon of war during the campaign. In September 2021, President Joe Biden threatened sweeping sanctions that drew a furious response from Prime Minister Abiy Ahmed.

The U.S. Agency for International Development had already suspended aid to Tigray on May 3 after it discovered that food assistance there was being rerouted and sold in local markets. The World Food Program paused its operations in Tigray in Aprilafter it too discovered that food aid was being diverted. The USAID administrator, Samantha Power, promised “a thorough review” of its programs in Tigray, where most of the region’s six million people rely on food assistance.

Since late March, USAID staff visited 63 flour mills in seven of Ethiopia’s nine regions, where they witnessed a “significant diversion” of American food aid, said the donor group’s briefing document, which described a “coordinated and criminal scheme” that deprived Ethiopia’s “most vulnerable” citizens of lifesaving assistance.

American investigators also found evidence that food from other countries had been stolen, as well, including wheat donated by France, Japan and Ukraine through the United Nations World Food Program, the largest food aid organization in Ethiopia.

The decision to suspend all American food aid will likely have major ramifications in Ethiopia, where several regions are currently enduring one of the worst droughts to sweep the Horn of Africa in decades.

Below-average rain, locusts and internal conflict have decimated the agricultural sector. At least 4.5 million livestock animals have also perished because of decreased grazing areas and water in the Oromia and Somali regions, according to the U.N. Food and Agriculture Organization.

The civil war and the Covid-19 pandemic have also exacerbated the economic situation in the country, leading to rising inflation and unemployment, shrinking safety nets and decreased foreign investments.

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