Why cholera continues to threaten many African countries

Samuel Kariuki, chief research scientist and director of the Centre for Microbiology Research at the Kenya Medical Research Institute, explains why the scourge of cholera is still prevalent across much of Africa

- Samuel Kariuki

Many African countries are periodically affected by outbreaks of cholera. For instance, Malawi’s current outbreak, the worst in two decades, has claimed hundreds of lives and forced the closure of schools and many businesses.

Cholera deaths have now been reported in South Africa too.

WHY IS CHOLERA STILL SUCH A BIG ISSUE FOR AFRICAN COUNTRIES? 

Cholera is a disease caused and spread by bacteria, specifically Vibrio cholerae, which you can get by eating or drinking contaminated food or water. It is an old disease that has mostly affected developing countries, many of which are in Africa. Between 2014 and 2021, Africa accounted for 21% of cholera cases and 80% of deaths reported globally.

In several African countries, cholera is the leading cause of severe diarrhoea. In 2021, the World Health Organization reported that Africa experienced its highest ever reported numbers: more than 137 000 cases and 4 062 deaths in 19 countries.

It has persisted in Africa partly because of worsening sanitation, poor and unreliable water supplies, and worsening socio-economic conditions. For instance, when people’s incomes cannot keep up with inflation, they will move to more affordable housing; often this is in congested, unsanitary settings where water and other hygiene services are already stretched to the limit.

In addition, in the last decade, many African countries have witnessed an upsurge in population migration to urban areas in search of a livelihood. Many of these people end up in poor urban slums where water and sanitation infrastructure remains a challenge.