Zambia battles increasing cholera cases amid global vaccine shortages

15 January 2024, 09:30
Contributor: Linda Ravenhill
 

ECHO Press Release, 12 January 2024
 

12 January 2024:  Zambia has reported a concerning increase in cholera cases in the country. ECHO (European Commission's Directorate-General for European Civil Protection and Humanitarian Aid Operation) 1 reported that the country's Ministry of Health had recorded a caseload of 8,276 new cases and 333 associated deaths since the reported start of its outbreak on 18 October 2023 ( 1).

\Most confirmed cases (94%) and deaths (97%) occurred in the Lusaka province, where water and sanitation conditions have been impacted by localised flooding. In response to the outbreak, the government has banned all street vending and public events and postponed the start of the school year by three weeks. According to ReliefWeb.co.za, the Disaster Management Authority is also finalising the revised Emergency Response Plan to assist in containing the disease.¹

Zambia, however, is not alone in facing this public health crisis. According to the WHO, the multi-country cholera outbreak will continue to pose a global threat in 2024. In the organisation's External Report, published on 11 January 2024, the number of cholera cases reported in 2023 exceeded those reported in 2022, with at least 30 member countries reporting a combined total of 67,000 cases and 4,000 associated deaths.  The WHO's Africa region carries the most significant burden of the diseases, with 17 countries – including Burundi, Burundi, Mozambique, Tanzania, Zambia, Zimbabwe and South Africa - reporting outbreaks last year. ²

Inadequate water and sanitation resources and the rapid growth of urban and peri-urban populations in these countries are significant contributory factors to the increase of the disease. Climate change has worsened the situation, with the rise in unseasonal flooding causing contamination of drinking water sources and increased regional migration, resulting in overcrowding and conditions conducive to outbreaks. 

As with any infectious disease, prevention is critical for better disease outcomes. Over and above the improvements to public health initiatives focused on clean water, improved sanitation, and reducing overcrowding in vulnerable communities, there is an Oral Cholera Vaccine (OCV) available to prevent the spread of cholera. There are, however, several challenges inhibiting its full-scale adoption. In the current outbreak context, only single-dose Oral Cholera Vaccine (OCV) regimens have been approved for reactive campaigns. Between 1 January 2023 and 31 December 2023, twelve countries submitted 30 requests to the International Coordination Group (ICG)  for emergency use OCV doses. In response to the requests, 33 million doses were dispatched, depleting all available stockpiles. ²

As of 9 January 2024, the global OCV stockpile is 1.1 million unallocated doses.

When considered against the reports that in December alone, Zambia, Ethiopia, Sudan, and Zimbabwe submitted new requests, representing a required 13,6 million doses, the scale of the task ahead for the WHO, the vaccine manufacturers and the countries affected by the disease becomes apparent.²


The WHO assesses the global risk for cholera outbreaks as very high based on all contributory factors.²