Despite cholera being a preventable and inexpensively treatable condition, recent data from the World Health Organization indicates a concerning rise in mortality rates, outstripping the increase in infection rates. Last year witnessed a 71% increase in cholera-related deaths worldwide, compared to a 13% rise in new cases. Factors such as climate-related disasters and ongoing conflicts are exacerbating the outbreaks, particularly in regions that have seen no recent cases.
Philippe Barboza, head of the cholera program at the WHO's health emergencies department, expressed dismay over the rapid escalation of death rates, emphasizing the global disregard for a disease that predominantly affects the most impoverished populations lacking access to clean drinking water.
In 2023, over 4,000 cholera fatalities were officially reported, but WHO estimates suggest the actual figures could exceed 100,000. The disease, characterized by severe dehydration due to intense diarrhea and vomiting, can be fatal within hours if untreated. Simple remedies like oral rehydration salts, which cost mere cents, are often sufficient to save lives.
The disease's footprint expanded last year, with 45 countries reporting cases, a sharp increase from 35 in the previous year. Africa, in particular, saw a 125% surge in cases, driven by extreme weather conditions that compromised water quality and sanitation.
Despite robust efforts in countries like Zambia and Malawi, health systems are struggling under the weight of large outbreaks. For instance, Zambia had to convert a stadium in Lusaka into a cholera treatment facility to manage the crisis.
In conflict zones like Sudan, despite severe challenges, health workers have managed to control outbreaks, although the situation remains precarious with the disease resurging recently.
The global response to cholera is also hampered by a vaccine shortage. In 2022, the managing organization of the global cholera vaccine stockpile recommended administering only one dose of the vaccine in outbreak regions to extend the limited supplies. This single-dose strategy provides shorter-term protection compared to the standard two-dose regimen.
As the demand for vaccines continues to outpace supply, countries grappling with outbreaks find themselves in need of more doses to prevent further spread. The sole manufacturer currently able to meet global demand, EuBiologics, plans to increase production, but even then, the supply will barely meet the escalating needs.
With new vaccine developments on the horizon, there is hope for better management of cholera outbreaks globally. However, the immediate challenges of vaccine availability and the need for stronger health infrastructure remain critical hurdles in combating this ancient yet preventable disease.
