McMaster Friends of MSF

Written By: Kabir Khatana and Roshan Puri

Cholera, an intestinal infection caused by the Vibrio Cholerae bacterium, has been recognized since as early as 1817.¹ The infection persists due to inadequate food and poor water quality, and it spreads through fecal contamination, posing a significant threat to countries lacking proper sewage disposal. Cholera leads to rapid fluid loss through diarrhea, vomiting, and sweating, which can be fatal. Emerging treatments, including vaccines and oral rehydration solutions, can temporarily manage the disease, but long-term solutions require improving sanitation in food and water to mitigate cholera permanently in Zambia.^2,4

Zambia has recently experienced a sudden and severe surge in cholera cases, exacerbated by poor water quality and limited food options. The global impacts of the Covid-19 pandemic have strained resources, hindering efforts to ensure sanitary water and food supplies.³ Additionally, climate change has caused record-breaking droughts in many Southern African countries, including Zambia, leading to a scarcity of safe drinking water. The remaining water sources are often unsanitized, contributing to the rise in cholera cases.³

Although vaccines are available, limited manufacturing capacity and regulatory processes have restricted the production of the oral vaccine amidst a fourfold increase in cholera cases. Since October 2023, Zambia has reported 19,000 positive cases and 700 fatalities.³

Médecins Sans Frontières (MSF) is one of the few emergency response teams active in Zambia. Sixty-one MSF staff members and 340 volunteers are collaborating with the Ministry of Health to address the immediate and long-term impacts of cholera.³ Cholera treatment centers distribute oral rehydration salts to mitigate the disease’s effects while waiting for vaccines. MSF has also developed 12 care facilities, known as Oral Rehydration Points, across Zambia to reduce hospital overcrowding.^2,3

Water sanitation experts in Zambia are working to treat and monitor the water supply to prevent future outbreaks. Advocacy for increased involvement of pharmaceutical companies in producing WHO-authorized vaccines is crucial to significantly reduce the impact of cholera and provide effective treatment for those affected.^2,3

The cholera surge in Zambia highlights the urgent need for global humanitarian aid and improved infrastructure to ensure clean water and sanitation. Collaborative efforts from international organizations, governments, and pharmaceutical companies are essential to control the outbreak and prevent future cases. By addressing these challenges, we can work towards a healthier future for Zambia and other affected regions.

References

1. Lippi D, Gotuzzo E, Caini S. Cholera. Microbiology Spectrum. 2016;4(4). doi:10.1128/microbiolspec.poh-0012-2015 

2. Responding to cholera is a multipronged approach: MSF. Médecins Sans Frontières (MSF) International. February 23, 2024. https://www.msf.org/responding-cholera-multipronged-approach.

3. Zambia: MSF responds to a surge in cholera amid regional outbreaks: MSF. Médecins Sans Frontières (MSF) International. February 28, 2024. https://www.msf.org/zambia-msf-responds-surge-cholera-amid-regional-outbreaks.

4. Cholera. World Health Organization. December 11, 2023. https://www.who.int/news-room/fact-sheets/detail/cholera.