Zimbabwe recently experienced a large-scale cholera outbreak, with a total of 34,549 suspected cholera cases reported from 2023 to 2024. A recent perspective has assessed the health implications of the cholera outbreak on the population in Zimbabwe and proposed a set of recommendations and future directions.
The country of Zimbabwe recently experienced a large-scale cholera outbreak, with a total of 34,549 suspected cholera cases reported from February 12, 2023 to June 30, 2024 [1]. A total of 718 cholera-related deaths were also reported (CFR 2.1%). A recent perspective by Olatunji and colleagues has assessed the health implications of the cholera outbreak on the population in Zimbabwe and proposed a set of recommendations and future directions [2].
Beyond the immediate health consequences of the crisis, the outbreak had wide reaching repercussions in affected areas, including effects on health, society, economy, labor and government resources. Under-resourced health facilities were overwhelmed by the patient surge. Overcrowding and long wait times in health facilities prevented timely care, leading to increased morbidity and mortality rates. Furthermore, public advisories discouraged attendance at open markets, social gatherings, and outdoor church camps, due to inadequate sanitation facilities. The government also imposed restrictions on schools, causing disruptions in education. During the outbreak, many people migrated from affected areas, which not only resulted in a local loss of labor and economic input, but also increased the risk of spreading cholera to other areas. To manage the outbreak, critical government resources had to be redirected from other essential government projects[2].
The Zimbabwean government, NGOs, and international agencies (WHO, IFRC and UNICEF) conducted comprehensive response efforts to mitigate the impact of the outbreak and prevent further spread, including case management, surveillance, public health measures, infrastructure improvements and community engagement. The Zimbabwean government, NGOs, and international agencies (WHO, IFRC and UNICEF) conducted comprehensive response efforts to mitigate the impact of the outbreak and prevent further spread, including case management, surveillance, public health measures, infrastructure improvements and community engagement. While immediate outbreak response efforts are crucial, sustainable efforts are also critically needed to address the root causes of cholera and prevent future outbreaks. This involves ongoing investments in long-term solutions such as improving access to clean water and sanitation infrastructure. Enhanced access to water and sanitation is not only vital for cholera prevention, it also shields communities from a wide range of infectious diseases. However, sustainability efforts are often challenged due to lack of financial resources, heavy reliance on external aid, political commitment, and stakeholder coordination2.
For long-term effectiveness, countries must develop self-reliance and build capacity to manage cholera outbreaks independently. Olatunji and colleagues have outlined a set of recommendations to more effectively and sustainably respond to cholera outbreaks in Zimbabwe[2]:
- Lessons learned: Post-outbreak reports should be institutionalized as a standard practice to integrate lessons learned into future cholera prevention and control strategies.
- Effective communication and community engagement: Public awareness campaigns aim to promote behavioral change by raising awareness about proper hygiene, safe water practices, and food preparation to minimize contamination. Communities in high-risk areas could establish local health committees responsible for monitoring water quality and hygiene practices, empowering the community to take ownership of cholera prevention.
- Stakeholder engagement: Partnerships and collaboration between stakeholders (e.g., Ministry of Health, international organizations, NGOs, and local community groups) should be strengthened to facilitate resource mobilization, share expertise, and coordinate effective cholera prevention and control efforts.
- Standardization and evaluation: Cholera case definitions should be standardized to ensure data accuracy. Furthermore, adaptable interventions are critical to address specific challenges, and local communities actively participate in the adaptation process. The effectiveness of implemented measures should be continuously evaluated to identify gaps and areas for improvement.
- Resource allocation: Rapid resource mobilization is crucial to control cholera transmission. A dedicated fund for cholera preparedness and response should be established to ensure that financial resources, medical supplies, and logistical support are readily available for a swift outbreak response.
- Capacity‐building: Before an outbreak occurs, capacity-building efforts should be boosted to ensure a coordinated and data-driven response. Training in epidemiological techniques enables epidemiologists to detect patterns and implement timely interventions. Ongoing training programs can strengthen health worker skills in cholera case management, which ultimately improves patient outcomes. Regular simulations are crucial for rapid response teams to master response protocols and function cohesively during an emergency. To effectively respond to and prevent cholera outbreaks in a sustainable manner, continuous professional development is essential.
- Infrastructure improvements: Balancing short-term outbreak response with long-term infrastructure improvements (e.g., water and sanitation) is crucial for comprehensive cholera control.
These recommendations could be adapted and applied in other countries facing similar public health challenges, enhancing cholera response efforts and bolstering overall resilience.