Malawi declares end of country's deadliest cholera outbreak

Violett Motta, a health surveillance assistant in Malawi, prepares disinfectant at a health center in response to a cholera outbreak in Blantyre, November 16, 2022. [Reuters]

Malawi has declared the end of the country's worst cholera outbreak, which began in March 2022 and killed nearly 2,000 people.

In a statement Monday, the Ministry of Health said the country had registered no cases or deaths from cholera in 26 of Malawi's 29 health districts in the past four weeks. Some health experts, however, said the outbreak could resurface if the country failed to address sanitation problems that caused it.

Malawi President Lazarus Chakwera launched a national campaign to end the cholera outbreak in February 2023. The “Tithetse Kolera” or “Let’s End Cholera” campaign came three months after he declared the disease to be a public health emergency in Malawi.

The campaign aimed to interrupt cholera transmission in all districts and reduce the fatality rate from 3.2% to below 1%, which the World Health Organization considers a controlled cholera outbreak.

Dr. Wilfred Chalamira Nkhoma, co-chairperson for the presidential task force on COVID-19 and cholera in Malawi, told VOA the disease had now been defeated largely because of the campaign.

“By WHO definition, a country stands to end the transmission of cholera when they have gone at least four weeks without reporting a laboratory-confirmed case of cholera," he said. "So that is the case with Malawi right now. We haven’t had a confirmed case since 6th of June.”

Successful steps

Nkhoma attributed the development to several interventions Malawi conducted over the past two years. He said they involved educating people about transmission, prevention and control of cholera; increasing surveillance; and properly managing cholera cases.

“The key one - and that must remain the key one - is to increase access to safe water and also improve adequate sanitation," he said. "The Ministry of Water and Sanitation was taking the lead in this, but they were supported very well by nongovernmental organizations that are working in the water and sanitation sector.”

Nkhoma said another measure was the oral cholera vaccination campaign, which began in December 2022.

“We were able as a country to access some doses from WHO," he said. "We were able to administer not less than about 6 million doses of cholera vaccine focusing first and foremost in priority areas.”

The Ministry of Health said in its Monday statement that Malawi had registered 56,376 cases of cholera, with 1,772 deaths since March 2022.

Maziko Matemba, a national community health ambassador in Malawi, told VOA that Malawi seemed to have managed the cholera outbreak at the treatment and case-management levels, but added that sanitation problems remained a challenge.

“Because at the moment, if you go to villages, if you go to public places, people are not doing the sanitation issues properly," Matemba said. "Even if you check in public toilets, even if you check how people are preparing food, you will find that we still have challenges as a country to contain disease like cholera.”

Nkhoma said the government would continue its effort to educate people about how cholera is transmitted, prevented and controlled to try to avoid further outbreaks.