The cholera epidemic that affected multiple countries in Eastern and Southern Africa in 2023 persists and continues to impact the region, placing additional strain on communities and healthcare facilities. Since 2023, 13 countries in the region have battled one of the worst cholera outbreaks to hit the region in years, and as of 15 January 2024, more than 200,000 cases, including over 3000 deaths, have been reported.
Since the first reported case in Zambia in October 2023, more than 9,500 people have been affected, and 374 deaths have been registered, with a case fatality rate of 3.9 per cent, a devastatingly high number. Nine out of 10 provinces are now reporting cholera cases. About 52 per cent of all cases in Zambia are children under 15 years. Lusaka, as the worst affected district, shares over 90 per cent of the disease burden.
In Zimbabwe, since the start of the outbreak in February last year, more than 18,000 cases have been reported across all 10 provinces, with 71 confirmed deaths and more than 300 suspected deaths. Harare and Manicaland Provinces are the most affected. One in six new cholera infections in Zimbabwe are affecting children under 5.
"The cholera outbreak in the region is a significant concern to the health and well-being of children. In the face of escalating challenges posed by cholera and other disease outbreaks, we thank governments for their major efforts in managing health crises, and all partners for their support to address the situation. Investments in strengthening systems to address the root causes of cholera and other public health emergencies, particularly on enhancing access to clean water, improved sanitation and hygiene, social behaviour change and quality of case management, are imperative," said Etleva Kadilli, UNICEF Regional Director for Eastern and Southern Africa.
"In addition, the impact of climate change, worsened by phenomena such as El Niño, further underscores the urgency of the situation. As we extend our unwavering support to ongoing government initiatives in ensuring clean water supply, safe sanitation, implementing vaccinations, and working with communities, among other critical interventions, a comprehensive response that not only addresses the immediate health crisis but also considers the broader implications for children in the region, is vital."
The outbreak has rapidly gained momentum in the region, placing an immense strain on healthcare systems and exposing vulnerabilities in sanitation and hygiene infrastructure. Inadequate access to clean water and sanitation facilities, and overcrowded living conditions, prevalent in many urban areas, exacerbate the risk of transmission.
Throughout the region, in addition to providing lifesaving supplies for prevention and treatment, UNICEF is working closely with Government agencies and community members to promote hygiene practices, improve water and sanitation infrastructure, and ensure that families have access to the information and resources they need to protect their children.
With additional measures to protect children, the new school year has resumed as planned in Zimbabwe. But in Zambia, the cholera escalation has led to the postponement of the start of the school until 29 January for all schools. Approximately 4.3 million learners are affected.
Kadilli expressed deep concern over the unfolding crisis, emphasizing the vulnerability of children in affected areas.
"The impact on children goes beyond the direct health consequences of cholera. Learning loss is a major concern. It is imperative that the response not only be swift but also considers the long-term well-being of these young children. As the new school year is starting in many countries in the region, it is crucial for measures to be put in place in schools to protect children against infections," she remarked.
Across the region, to mitigate the impact of multiple public health emergencies, UNICEF continues to work towards and advocate for sustained investments in resilient healthcare systems and water and sanitation infrastructure, including the promotion of safe hygiene practices and community engagement. UNICEF's programmes for children in the region have been made possible thanks to dedicated donors and partners, and donors are urged to continue prioritizing funding to protect children in the region.
UNICEF's actions to reduce the impact of the cholera outbreak and protect children in the region include:
Zimbabwe
- UNICEF and partners have reached more than 190,000 people, including 87,000 children, with safe water since the outset of the outbreak.
- UNICEF provided supplies to more than 50 cholera treatment centres for the treatment of patients.
- UNICEF and partners have reached 4.4 million people with cholera messages on infection prevention and control and access to services, including an ongoing cholera-prevention back-to-school campaign.
- UNICEF is supporting the Government towards Oral Cholera Vaccination, targeting 2.2 million people in 29 high-risk districts in 8 provinces.
Zambia
- UNICEF has provided to the Ministry of Health (MOH) 30 Acute Watery Diarrhoea (renewable) kits, which can treat about 3,000 people; supplied 6 high-performance tents to different outbreak districts; and donated 320,000 sachets of ORS to the MoH. In addition, other medical supplies, including IV fluids, antibiotics, paracetamol tablets, zinc sulphate tablets, infusion sets for the IV fluids and water purifying tablets, have been provided to treat the more than 7,000 cholera patients recorded so far. UNICEF is further providing procurement services and logistics for the procurement of cholera rapid diagnostic kits funded by Gavi, the vaccines alliance.
- In addition, UNICEF and WHO have handed over 1.4 million Oral Cholera Vaccines to the Ministry of Health today (15 January 2024).
- In the area of WASH, UNICEF has provided technical assistance such as cluster coordination, technical assessments, and water quality monitoring, as well as 834 boxes of 12 liquid chlorine, 31 containers of granular chlorine, 2,068 buckets and 20 boxes of liquid soap reaching about 70,000 people.
- UNICEF has supported the training and deployment of 240 Community-Based Volunteers (CBV) through the Red Cross Society (ZRCS) and an additional 350 CBVs through direct support to the Government of Zambia, which are targeting about 2.4 million people throughout the country with cholera messages on prevention and access to services. Moreover, UNICEF is supporting the Ministry of Health with Public Service Announcements on cholera aired on national TV and radio stations expecting to reach about 2 million and 5 million people respectively.
- UNICEF is also providing psychosocial support through helplines. Between December and January 10th, about 3,600 callers were supported.
