Deadly cholera outbreak hits southern Africa

Cholera Outbreaks in Africa: A Report on the Current Situation

Introduction

Since the beginning of 2024, Africa has been grappling with a series of deadly cholera outbreaks, resulting in more than 1,000 deaths and tens of thousands of infections. This report focuses on the impact of these outbreaks in several African countries and explores the factors contributing to their spread.

Cholera Outbreaks in Southern Africa

The hardest hit nations in southern Africa are the Democratic Republic of the Congo, Mozambique, Zimbabwe, Zambia, and Ethiopia. Among these, Zambia is experiencing its worst outbreak ever, with over 740 cholera-related deaths recorded since October 2023.

The Spread of Cholera

Cholera outbreaks are often observed in disaster-hit areas or impoverished communities lacking access to safe drinking water and proper sanitation. Individuals who rely on untreated water sources or live in slums and refugee camps are particularly vulnerable. The Vibrio cholerae bacteria responsible for cholera is transmitted through contaminated food and water supplies, making the situation worse in households where toilets are located close to water sources. Refugee camps, with their high population density, also face significant challenges due to the highly contaminated water used by residents.

Factors Contributing to Cholera Outbreaks

Epidemiologist Yap Boum highlights that cholera outbreaks are often associated with countries exposed to conflict, insecurity, and poverty. These factors are prevalent in the African nations currently battling cholera. Additionally, climate change plays a role, as increased flooding linked to climate change leads to more pathogens in water sources, increasing the risk of contamination.

Challenges with Cholera Vaccines

The only available oral cholera vaccine is in high demand, with stockpiles currently empty. The single manufacturer, based in South Korea, is producing 700,000 doses per week, but the demand is four times greater than the supply. Despite a recommendation to switch to a single-dose regimen to preserve stocks, the shortage persists. Cholera vaccines are produced on a “needs basis,” primarily for mass vaccination programs during outbreaks. This limited production capacity contributes to the current vaccine shortage.

Vaccines as a Solution

While the production of cholera vaccines has increased significantly over the past decade, it still falls short of meeting the demand caused by the surge in cholera cases. Experts emphasize that vaccines alone cannot solve the problem and should be viewed as one tool among many. Other measures include improving community health messaging, providing safe water sources, and increasing water quality testing and monitoring.

Regional Vaccine Production

A regional manufacturer based in South Africa, Biovac, signed a licensing contract to produce oral cholera vaccines. However, production is not scheduled to start until 2026, making it ineffective in curbing current outbreaks. Nevertheless, having a regional manufacturer is seen as a step in the right direction, enabling countries to take ownership and better support their health programs.

Conclusion

The cholera outbreaks in Africa highlight the urgent need for sustainable development goals (SDGs) related to clean water and sanitation (SDG 6) and good health and well-being (SDG 3). While vaccines play a role in disease control, addressing underlying factors such as poverty, conflict, and climate change is crucial for long-term containment. By investing in regional vaccine production and improving access to safe water sources, African nations can take significant strides towards preventing future cholera outbreaks.

SDGs, Targets, and Indicators

1. SDG 3: Good Health and Well-being

   • Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases.
   • Indicator 3.3.1: Number of new HIV infections per 1,000 uninfected population, by sex, age, and key populations.
   • Indicator 3.3.2: Tuberculosis incidence per 100,000 population.
   • Indicator 3.3.5: Number of people requiring interventions against neglected tropical diseases.
   • Indicator 3.3.6: Number of cases and deaths from selected water-borne diseases.

2. SDG 6: Clean Water and Sanitation

   • Target 6.1: By 2030, achieve universal and equitable access to safe and affordable drinking water for all.
   • Target 6.2: By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations.
   • Indicator 6.1.1: Proportion of population using safely managed drinking water services.
   • Indicator 6.2.1: Proportion of population using safely managed sanitation services, including a handwashing facility with soap and water.

3. SDG 13: Climate Action

   • Target 13.1: Strengthen resilience and adaptive capacity to climate-related hazards and natural disasters in all countries.
   • Indicator 13.1.1: Number of deaths, missing persons, and directly affected persons attributed to disasters per 100,000 population.

Analysis:

1. SDG 3: Good Health and Well-being

   The article discusses the cholera outbreaks in Africa, which is a water-borne disease and falls under the category of communicable diseases. Target 3.3 aims to combat water-borne diseases, including cholera. The indicators mentioned in the article, such as the number of cases and deaths from water-borne diseases, can be used to measure progress towards this target.

2. SDG 6: Clean Water and Sanitation

   The article highlights the role of safe drinking water and proper sanitation in preventing cholera outbreaks. Target 6.1 focuses on achieving universal access to safe drinking water, while target 6.2 aims to achieve access to adequate sanitation and hygiene. The indicators mentioned in the article, such as the proportion of population using safely managed drinking water and sanitation services, can be used to measure progress towards these targets.

3. SDG 13: Climate Action

   The article mentions that climate change, particularly increasing flooding, has an impact on cholera outbreaks. Target 13.1 aims to strengthen resilience to climate-related hazards and natural disasters. The indicator mentioned in the article, the number of deaths and affected persons attributed to disasters, can be used to measure progress towards this target.

Table: SDGs, Targets, and Indicators

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Source: dw.com

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