Rain lashes the ground in northern Zambia, but the mission presses on. It’s a Wednesday in January, and the showers that drench this region—bordering the Democratic Republic of Congo to the north and east—have done little to dampen the resolve of four epidemiologists. They are here on a 14-day mission, working urgently to contain simultaneous outbreaks of cholera, mpox, and measles.
With a combined 40 years of expertise, Dr. Abiodun Kolapo and Tesfa Getanew—both from Africa CDC—along with Benaiah Simatele and Paul Linde from the Zambia National Public Health Institute (ZNPHI), are seasoned outbreak responders. Now, their skills are being put to the test.
Zambia has been battling its worst cholera outbreak on record since October 2023, with the majority of cases reported in December 2023 and January 2024. At the same time, a growing mpox outbreak has been unfolding since October 2024, after the first reported case—linked to a foreign national—triggered local transmission. The disease is now spreading, with cases confirmed in Lusaka, Kitwe, and Mufulira districts in the Copperbelt Province.
By late January, eight new mpox cases were detected, bringing the total to 15. Meanwhile, measles remains a pressing public health challenge, with Zambia reporting 1,651 suspected cases and 469 confirmed cases in 2023 alone.
As of February 6, 2025, the Copperbelt Province remained under strain, having recorded 140 cholera cases, five confirmed mpox cases, and seven measles cases.
Africa CDC, through the Southern Africa Regional Coordinating Centre (SA-RCC) and ZNPHI, launched a swift response by deploying a team of highly skilled experts to the affected province. Their first stop was the Copperbelt Provincial Health Office, where they met with Provincial Health Director Dr. Charles Mwuinuna. He expressed deep appreciation for Africa CDC’s critical partnership and support in tackling the complex challenge of responding to simultaneous mpox, cholera, and measles outbreaks.
Dr. Mwuinuna highlighted key challenges, including limited funding, weak surveillance systems, and inadequate response capacity at lower levels.
“This clearly underscores the urgent need for on-site technical support to bridge these gaps and strengthen surveillance and response capacities,” he emphasized
The minister emphasized that the outbreaks also provided an opportunity to strengthen integrated disease surveillance, increase community engagement, and adopt innovative approaches to build more resilient health systems.
To support the response, the team delivered integrated technical assistance to provincial and district health units, including health facilities in Kitwe, Mufulira, and Chililabombwe—key border districts critical to containment efforts. This support included engagement meetings with provincial and district health directors, health management teams, and IMS pillars—covering surveillance, risk communication and community engagement, case management, infection prevention and control, and vaccination—along with on-site visits to health facilities,” the team reported.
The technical assistance focused on three key outbreak responses. For the mpox outbreak, the team provided technical guidance, conducted on-site training for health workers across six health facilities, led case investigations, and distributed surveillance tools and Information, Education, and Communication (IEC) materials to strengthen case detection and reporting.
At points of entry (PoE) and border crossings, they assessed two key PoEs, identifying gaps and delivering tailored recommendations to improve border health security. For the cholera outbreak, the team mentored district rapid response teams, supported Water, Sanitation, and Hygiene (WASH) interventions, and enhanced surveillance data management to strengthen the overall outbreak response.
The PoE assessment at Mokambo and Kasumbalesa exposed critical weaknesses, including a shortage of personnel, a lack of specialized training, and inadequate personal protective equipment.
“The assessment further highlighted the absence of contingency plans, standard operating procedures, emergency mobility equipment—such as ambulances—real-time surveillance and reporting systems, and quarantine facilities,” said Dr. Kolapo.
Additionally, inadequate vector control measures and the lack of specialized animal inspection services emerged as significant concerns, posing a serious threat to border health security.
Kasumbalesa is the epicenter of the current cholera outbreak in Chililabombwe district. The Africa CDC team, together with other partners, joined Zambia’s Minister of Health, Dr. Elijah J. Muchima, and his delegation to meet and support the cholera outbreak response team and frontline workers.
Dr. Muchima commended the tireless efforts of all stakeholders and partners working collaboratively to mitigate the impact of the outbreak and restore normalcy. His visit reinforced high-level political commitment to the cholera response, boosted the morale of frontline health workers, and strengthened community trust in the government’s efforts. His presence also reaffirmed the government’s leadership in coordinating partner interventions, ensuring that response activities align with national priorities, and demonstrating its dedication to safeguarding public health.
A few weeks after the field visit, Africa CDC and WHO continued to report multiple disease outbreaks in neighboring countries, raising concerns about potential for international spread. The need for improved surveillance at points of entry (PoEs) was identified as a priority.
“Targeted training for health workers in high-risk districts with points of entry could help control the outbreaks,” said Dr. Kolapo. Subsequently, the Government of Zambia, in collaboration with the Mpox Incident Management Support Team(IMST), led by Africa CDC and WHO with support from UNICEF, the International Federation of Red Cross and Red Crescent Societies, the International Organization for Migration, the UK Health Security Agency, and other health partners, organized a training for health workers from high-risk districts from March 4-7, 2025. Participants came from all ten Zambian provinces. The goal was to strengthen local capacities in line with the International Health Regulations (2005), ensuring a robust response to potential disease outbreaks.
