Cholera is a major public health problem, but the burden and impact of the waterborne disease is greatest in sub-Saharan Africa.
In 2017, more than 150,000 cholera cases including more than 3,000 deaths were reported in 17 countries in Africa. This year has been no different, and there are eight countries currently battling outbreaks.
One of them is Zimbabwe, whose government has declared a state of emergency in Harare, following an outbreak of waterborne diseases such as typhoid and cholera, with more than 2,000 cases and 20 deaths.
Cholera, an infectious disease, presents with a sudden onset of watery diarrhoea and vomiting, associated with ingestion of water or food contaminated with cholera germs.
According to Zimbabwe’s Minister for health Obadiah Moyo, the situation has been worsened by poor water supply, blocked sewers and uncollected waste.
Similar problems dog Kenya, which has recorded intermittent outbreaks in recent years.
In May 2017, the first two cases were reported in Mathare, Nairobi County. Cumulatively, 146 cases and four deaths were reported by mid-last year in counties such as Garissa, Vihiga, Mombasa, Murang’a and Kiambu.
The persistent cholera problem has informed the pledge by 47 countries in the World Health Organisation Africa region, to commit more resources and implement strategies to end cholera outbreaks by 2030.
The countries adopted the Regional Framework for the Implementation of the Global Strategy for Cholera Prevention and Control, at the 68th session of the WHO’s Regional Committee for Africa.
Health ministers pledged to reduce the magnitude of cholera outbreaks among vulnerable populations and during humanitarian crises by 90 per cent.
They also agreed to enhance surveillance including cross-border surveillance, map cholera hot spots, improve access to timely treatment, increase investments in clean water and sanitation and use the oral cholera vaccine for the most vulnerable communities.
In Uganda, the government has launched a vaccination campaign, targeting more than 1.6 million people, including children over one year, in the 11 cholera hot-spot districts, as part of the National Cholera Control Plan that runs till 2022.
“Cholera is a symbol of inequity,” said Dr Matshidiso Moeti, the WHO Regional Director for Africa, and added that the ancient disease had been eliminated in many parts of the world.
“Every death from cholera is preventable. We have the know-how, and today countries have shown that they have the will to do what it takes to end cholera outbreaks by 2030.”
“WHO is working hand-in-hand with countries, providing key technical expertise and guidance,” he said, and added that countries must expand the use of the highly effective oral cholera vaccine.
Africa is vulnerable to cholera because 92 million people still drink water from unsafe sources. In rural areas, where piped water is often unavailable and people practise open defecation, water gets contaminated.
Humanitarian crises, climate change, rapid urbanisation and population growth also increase the risk of cholera spreading.
From 2013 to 2017, the WHO supported 65 cholera vaccination campaigns and supplied more than 16 million doses of vaccines to 18 countries around the world, including 11 in Africa.
Many of the campaigns in Africa have taken place in the context of a humanitarian crisis or natural disaster. To deal with risk factors such as rapid urbanisation and poor sanitation which lie outside the health sector, the WHO is working with partners to engage all relevant sectors to build a comprehensive and sustainable response throughout the region.
African countries pledge to eliminate cholera outbreaks #HealthyNation https://t.co/UwGYXJphB5
— Daily Nation (@dailynation) September 18, 2018