Cholera, 25 countries have already reported outbreaks since the beginning of this year, 22 others risk the same epidemic

ROME – The current global cholera situation is unprecedented due to the alarming size of the outbreaks, the geographical spread and the extraordinarily high rate of deaths. Here is a summary of the picture outlined by Jérôme Pfaffmann Zambruni, head of theEmergency Unit for the public health ofUNICEF

– 25 countries have already declared outbreaks since the beginning of 2023. And we are less than halfway through the year. According to a new analysis, 22 more countries around the world are at risk of declaring cholera outbreaks.

– Over the past 10 years, the world has seen a steady decline in cholera. But the trend has reversed: in 2021 there was a surge in cases which continued in 2023. As of May, 24 countries are reporting cholera outbreaks, compared to 15 last year. If the trend continues, especially as West Africa is entering the wet season, we could exceed the annual total number of countries battling outbreaks in 2022 and 2021.

– This is a disease that no one should die of. Mortality rates above 1% usually signal problems in the quality, access and speed of care. As outbreaks arise in many more countries, we are also seeing more deaths from cholera than ever before. For example, 3 out of 100 people infected with the disease have died in Malawi (since the outbreak began in March 2022) and Nigeria (and Nigeria in 2023).

The fight against time. The longer people are left without the support they need to control and prevent cholera, the more the disease spreads and the more funding needs grow. It’s about more than money, it’s about communities that need support. In November 2022, UNICEF launched an appeal for donors for $150 million to respond to cholera outbreaks. But support has been scant. Since then, in just six months, the call for funding has grown by 220%, while the situation has become more and more serious. Inaction costs lives, and money.

An unprecedented gravity. The cholera upsurge, with an unprecedented scale, increase and severity, is an urgent wake-up call for us to act together and now: protect those affected by the current outbreaks and invest in underlying sanitation and water services . The situation is bound to get worse. We know that it’s not a question of if, but of when. We are seeing climate change as a multiplier of vulnerability. As climate shocks increase in number and intensity and temperatures rise, damage to water and sanitation services, contamination of safe water sources and increased displacement of people will increase.

A look at the cyclones that hit. Think, for example, of cyclones like Freddy in Mozambique and Malawi, the floods in Pakistan and Nigeria last year or the drought in the Horn of Africa, which have created favorable conditions for waterborne diseases. In the aftermath of Cyclone Mocha in Myanmar and Bangladesh, UNICEF fears the risk of waterborne diseases could increase in the coming days. Climate change is also making “cholera seasons” less predictable. Although large parts of the world are currently at “low cholera transmission,” it is concerning that many are still witnessing outbreaks during a period traditionally characterized by little or no transmission. We will see even more widespread outbreaks as the world enters “high cholera seasonality.”

Cholera: the pandemic of the poor. For the next twelve months, UNICEF urgently needs $480 million for immediate cholera prevention and response interventions in the areas of health, water and sanitation and risk communication, and community engagement for social and behavioral change. Cholera has long been a “pandemic of the poor”. It is unacceptable that little attention and support has been given to the vulnerable people who are affected. Cholera is an indicator of poverty and exclusion. It disproportionately affects poor and vulnerable communities that lack access to basic services and where health systems are weakest. Cholera is increasingly present in fragile and emergency contexts. Since 2019, cholera outbreaks have occurred in more than half of the countries experiencing humanitarian emergencies.

The absence of water systems. Underinvestment in water and sanitation systems is an accurate risk indicator for cholera: 97% of cholera cases from 2010 to 2021 occurred in countries with the lowest water and sanitation levels in the world. Without access to safe water and sanitation, preventing and controlling the transmission of cholera and other waterborne diseases is virtually impossible.”