LILANDA, Zambia – Extreme weather events have hit parts of Africa relentlessly over the past three years, with tropical storms, floods and droughts causing famines and displacement. They leave behind another deadly threat: some of the continent’s worst cholera outbreaks.
In southern and eastern Africa, more than 6,000 people have died and nearly 350,000 cases have been reported since a series of cholera outbreaks began in late 2021.
Malawi and Zambia have had the worst outbreaks on record. Zimbabwe had multiple waves. Mozambique, Kenya, Ethiopia and Somalia were also seriously affected.
All have suffered floods or droughts — in some cases, both — and health officials, scientists and aid agencies say the unprecedented rise in waterborne bacterial infection in Africa is the latest example of how weather conditions extremes are playing a role in driving disease outbreaks. .
“Outbreaks are increasing a lot because extreme weather events are becoming much more common,” said Tulio de Oliveira, a South Africa-based scientist who studies diseases in the developing world.
De Oliveira, who led a team that identified new variants of the coronavirus during the COVID-19 pandemic, said the latest outbreaks in Southern Africa can be attributed to the cyclones and floods that hit Malawi in late 2021 and early 2022, carrying the cholera bacteria to areas where it does not exist. normally does not reach.
Zimbabwe and Zambia have seen a rise in cases as they face severe drought and people rely on less safe water sources in their desperation, such as boreholes, shallow wells and rivers, which may be contaminated. Days after deadly floods in Kenya and other parts of East Africa this month, cases of cholera emerged.
The World Health Organization considers cholera a disease of poverty, as it thrives where there is poor sanitation and a lack of clean water. Africa has had eight times more deaths this year than the Middle East, the second most affected region.
Historically vulnerable, Africa is even more at risk as it faces the worst impacts of climate change, as well as the effect of the El Niño climate phenomenon, health experts say.
In what has become a perfect storm, there is also a global shortage of cholera vaccines, which are only needed in the poorest countries.
“This does not affect countries with resources,” said Dr. Daniela Garone, international medical coordinator for Doctors Without Borders, also known by its French acronym MSF. “So, it doesn’t bring the resources.”
Billions of dollars have been invested in other diseases that predominantly affect the world’s most vulnerable, such as polio and tuberculosis, largely because these diseases are highly contagious and can cause outbreaks even in rich countries. But this is not the case with cholera, where epidemics remain contained.
The WHO said this month that there is a “critical shortage” of oral cholera vaccines in the global stockpile. Since the start of 2023, 15 countries — the desperate few — have requested a total of 82 million doses to deal with deadly outbreaks, while only 46 million doses were available.
Only 3.2 million doses remain, below the target of having at least 5 million in reserve. Although there are currently cholera epidemics in the Middle East, the Americas and Southeast Asia, Africa is by far the most affected region.
The GAVI and UNICEF vaccine alliance said last month that approval of a new cholera vaccine would boost stocks. But the result of the shortage has already been measured in deaths.
Lilanda, a town on the edge of Zambia’s capital Lusaka, is a typical cholera hotspot. Puddles of stagnant water dot the dirt roads. Clean water is like gold dust. Here, during two terrible days in January, Mildred Banda watched her 1-year-old son die of cholera and ran to save her teenage daughter’s life.
Cholera shouldn’t be killing anyone. The disease is easily treated and prevented – and vaccines are relatively simple to produce.
This did not help Banda’s son, Ndanji.
When he fell ill with diarrhea, he was treated with oral rehydration solution at a clinic and discharged. He became dehydrated again that night at home. Banda feels terrible guilt.
“I should have realized sooner that my son wasn’t feeling well,” she said, sitting in her little concrete house. “I should have acted faster and taken him back to the clinic. I should have taken him back to save his life.”
Due to vaccine shortages, Zambia was unable to carry out a preventive vaccination campaign following the outbreak in neighboring Malawi. That should have been a wake-up call, Oliveira said. Zambia only made an emergency request when cases began to rise.
The doses that could have saved Ndanji began arriving in mid-January. He died on January 6th.
In Zimbabwe, a drought worsened by El Niño has caused cholera to spread to far-flung rural areas as well as its traditional hotspots of populated urban neighborhoods.
Abi Kebra Belaye, MSF representative in Zimbabwe, said the southern African country typically has around 17 hard-hit areas, most of them urban. This year, cholera spread to 62 districts as the struggle to find water increased the risk.
“This part of Africa is paying the highest price for climate change,” said Kebra Belaye.
Augustine Chonyera, from a cholera-prone area of the capital Harare, was shocked when he recently visited the sparsely populated rural district of Buhera.
He said he had heard grim stories about the disease’s impact: a family that lost five members, a husband and wife who died within hours of each other, and local businesses that used delivery trucks to take patients to a clinic several miles away. distance.
“It seems now that people in rural areas are in more danger than we are. I still wonder how this happened,” Chonyera said.
He said he returned home as soon as he could – after giving a large bottle of treated water he brought with him to an elderly woman.
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Mutsaka reported from Harare, Zimbabwe. Imray reported from Cape Town, South Africa.
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