/ 30 May 2023

South Africa joins countries grappling with cholera on the continent

Malawi Cholera
Healthcare workers move a body from a makeshift mortuary at a cholera treatment centre at Bwaila district hospital in Lilongwe in February. Photograph: Fredrik Lerneryd/AFP/Getty Images

The cholera outbreak, which has caused the death of more than 20 people, has rattled South Africans, but in Eastern and Southern Africa, the disease is a familiar occurrence.

Cholera was largely eliminated from industrialised countries through water and sewage treatment more than a century ago, but there are a significant number of cases each year in many African countries.

In March, the United Nations Children’s Fund (Unicef) said 11 countries in Eastern and Southern Africa were battling with one of the worst cholera outbreaks to hit the region in years. It said 28 million people were in need in Malawi, Mozambique, Somalia, Kenya, Ethiopia, Zambia, South Sudan, Burundi, Tanzania, Zimbabwe and South Africa.

To respond to the increasing needs of children and families affected by cholera, the United Nations Children’s Fund said it was urgently calling for funding of $171 million for emergency health supplies, medical products, technical support for outbreak control, risk communication and community engagement for prevention and early treatment, as well as safe water and nutrition supplies.

Zimbabwe, which had gone for three years with no outbreak, recorded one on 12 February, and 1 285 cases had been noted by 21 May, affecting 26 districts.

The World Health Organisation (WHO) has donated cholera kits and medical supplies to Zimbabwe’s health ministry as part of ongoing efforts to combat the cholera outbreak. The kits include antibiotics, oral rehydration salts, intravenous fluids, and medical sundries such as gloves and syringes. 

(John McCann/M&G)

According to the WHO, the increase in cholera cases in districts that were previously non-cholera hotspots has created pressure on Zimbabwe’s already fragile health system of the country. 

In addition, most cases are being recorded in areas that had not been previously targeted for oral cholera vaccine while access to clean water and sanitation is also a problem in these areas.

Zimbabwe had its largest cholera outbreak from August 2008 to July 2009, when 98 592 cases and 4 288 deaths were recorded. The cumulative case fatality ratio was 4.3%, well above the WHO’s recommended threshold of less than 1%.

In March, health ministers and those of water and sanitation from 12 African countries, as well as technical experts, attended an emergency meeting on cholera and agreed on collaborative measures to combat the spread of the disease.

The ministers from Angola, Botswana, the Comoros,Congo, eSwatini, Lesotho, Malawi, Mozambique, Namibia, Tanzania, Zambia and Zimbabwe endorsed the establishment of a cholera task force, the scaling-up of cholera prevention and control through robust community engagement, stronger surveillance and cholera vaccine availability and enhanced water, sanitation and hygiene services across countries.
Cholera is a highly infectious disease that is caused by the ingestion of food or water contaminated with the bacterium Vibrio cholerae. The disease is characterised by severe diarrhoea and vomiting, which can lead to dehydration and death if left untreated.