Africa Watch – Health and hollow systems

A cholera outbreak in Malawi has killed at least 1,210 people, the World Health Organization announced on Thursday,  asking for strong interventions to prevent the situation from worsening. The Southern African country saw a 143-percent increase in the number of cases last month compared to December. Nearly 37,000 cases have been reported since March 2022. Malawi has carried out two large vaccination campaigns since the outbreak began. However, due to limited supplies, the authorities offered just one of the usually recommended two oral cholera vaccine doses. A health ministry spokesman said, last month, that all the doses had been used. 

Source: The Lancet

In response to the latest outbreak, Malawi’s government launched an End Cholera campaign on 13th February, with a focus on bringing the fatality rate down to 1% from 3.2 and it hopes to do this by increasing access to appropriate cholera prevention and treatment health care services; increasing access to safe water, sanitation and improved food hygiene; and strengthening risk communication, community involvement, and social mobilisation in cholera prevention and treatment.

One primary reason for the uptick in the cholera outbreak in the country was the 2022 floods, the last of whose impacts are yet to be seen. The sanitation issues that the flood caused were left unattended to by the country’s health department and as a result, the government finds its latest anti-cholera campaign threatened by not just poor sanitation, but also slow vaccination rates, coupled with its handling of critical cases, especially in the worst hit areas of the country which includes Lilongwe, Balaka, Blantyre, Mangochi and Machinga.

A wetter-than-usual rainy season may be fuelling the surge in cholera cases not only in Malawi but right across the continent. According to the WHO, nearly 80,000 cases and 1,863 deaths were reported in 15 countries in 2022. Those trends appear to have continued this year; so far, an estimated 26,000 cases and 660 deaths have been reported as of 29 January in 10 African countries. That is on pace to surpass the case numbers for 2021 – the worst year for the epidemic in nearly a decade.

With the social and institutional stressors which the COVID-19 pandemic heaped on health systems across the continent, and the threats posed by emerging maladies such as Ebola and endemic ones such as malaria and HIV/AIDS, governments across the continent must prioritise investment in health infrastructure, waste management systems as well as public education campaigns if the continent is not to be sideswiped by yet another health catastrophe. This should rank as one of the most urgent governance priorities considering the short-term projections for another unseasonably wet rainy season and the long-term effects of climate change.