Summary
On 20 January 2024, Africa CDC sensitised Heads of State and Government from the Southern Africa Development Community (SADC) regarding the increase of cholera-related cases and deaths in the region.
Heads of State and Government then decided to organise an extraordinary summit hosted by the SADC Secretariat and led by President Lourenco from Angola as the Chair of SADC. This meeting was held virtually on 2 February 2024 to receive and consider a report on the status of the cholera outbreak in the SADC region. They expressed concern on the progress made in curbing the situation and the challenges that continue to hamper the effective fight against the recurrent outbreaks.
The extraordinary summit followed the meeting of the Committee of SADC Ministers of Health on 27 January 2024 and the SADC Executive Council (Ministers of Foreign Affairs) on 29 January 2024.
What We Know
The cholera situation in Africa is aggressive and more protracted in multiple countries. From January 2023 to January 24, 2024 (13 months), a total of 252,934 cases and 4,187 deaths (CFR 1.6%) have been reported from 19 African Union Member States. Over 72.5% of the total cases are reported from the SADC region.
Table 1: Reported Cholera cases and deaths in the SADC region from 1st January 2022 to 24th January 2024
| Country | # cases | Total deaths | CFR | Reporting endpoint |
| DRC | 71,023 | 766 | < 1 | Jan 2024 |
| eSwatini | 2 | 0 | – | April 2023 |
| Malawi | 59 106 | 1 771 | 3 | Jan 2024 |
| Mozambique | 54,948 | 168 | < 1 | Jan 2024 |
| South Africa | 1076 | 47 | 3.4 | Jan 2024 |
| Tanzania | 1,253 | 26 | 2.1 | Jan 2024 |
| Zambia | 14,116 | 662 | 3.7 | Jan 2024 |
| Zimbabwe | 20,447 | 425 | 2.2 | Jan 2024 |
*Source: Member States
1. The cholera situation is created and/or exacerbated by climate change. The climate outlook for the SADC region for the period between December 2023 and February 2024 projection increased chances of normal to above-normal rainfall in Angola, Botswana, DRC, Lesotho, Malawi, Mozambique, Namibia, South Africa, Tanzania, Zambia, and Zimbabwe.
2. The overall performance results from the WHO Afro cholera readiness and preparedness survey conducted in 2023 indicated a limited capacity in Water Sanitation and Hygiene (WASH) infrastructure amongst the SADC countries. As the region continues to experience an increase in cholera outbreaks, more investments in cholera preparedness and readiness are urgently required.
3. The Director General of Africa Centers for Disease Control and Prevention (Africa CDC), H.E. Dr. Jean Kaseya, emphasised that cholera is not only a health sector problem. He advised adopting a multisectoral approach to eliminate cholera in the continent, considering the long-term investment in Water, Sanitation, and Hygiene facilities across Member States. He reiterated that the main driver for cholera outbreaks is limited access to water, hygiene and sanitation, which requires significant involvement of other sectors.
Recommendations for Action
4. The Heads of State and Governments for the SADC region unanimously agreed on the following recommendations and action in addressing the Cholera outbreak in the region by urging Member States to:
a) Develop and implement regional solid and country multisectoral response plan that encompasses natural disasters and climatic effects on cholera re-emergence to control its spread effectively,
b) strengthen regional collaboration on cross-border outbreak risk assessment and public health surveillance to enhance early detection and prevention of outbreak-prone diseases,
c) jointly plan and implement synchronised cross-border cholera vaccination campaigns, as appropriate, and mobilise vaccines for affected and non-affected countries., and report to the council annually,
d) increase investment in the current cholera emergency response while long-term investment for a sustainable solution to the recurrent cholera crisis,
e) develop and implement climate-resilient water, sanitation and Hygiene (WASH) and Disaster Risk Reduction programmes to prevent future cholera outbreaks,
f) Accelerate local and regional manufacturing of cholera vaccines to scale up production and increase access to commodities such as Oral rehydration Solutions (ORS) and Cholera beds to improve control on the supply chain security and accelerate technology and knowledge transfer,
g) Increase investment in WASH infrastructure and provide efficient waste management and sustainable supply of clean water,
h) Increase budget allocation towards WASH Programmes and
i) Strengthen accountability tools for monitoring WASH interventions and local governments reporting on their WAS performance.
5. The SADC Summit commended the Africa CDC for technical and financial support towards the cholera response in the SADC region and recommended the AFRICA CDC to bring more epidemiologic data to facilitate the decision to Heads of State and Government to declare Cholera as a Public Health Emergency of Regional concern.
6. The Summit further designated His Excellency Mr Hakainde Hichilema, President of the Republic of Zambia, as the regional Cholera Champion to spearhead the fight against Cholera in the SADC region.
7. In response to this SADC Extraordinary Summit, the Director General of Africa CDC welcomes the recommendations from the Heads of State and Government and reiterates his commitment to work with the Member States and partners to urgently contain the ongoing Cholera outbreak by deploying personnel and resources in collaboration with the Ministries of Health.
8. The Africa CDC counts on the commitment of Member States to address the root cause of the recurrent cholera outbreaks to attain the goal of Cholera elimination by 2030.
Additional Resources:
Communication and Public Information Directorate, Africa CDC, Email: Communications@africacdc.org | Ms. Ndahafa Nakwafila at: NakwafilaN@africacdc.org
Done on 02 February 2024
