LUSAKA, December 14, 2023

Today, I address you with urgency on the ongoing cholera outbreak threatening our health security in Zambia. The outbreak has been in Lusaka Province and recently Eastern Province as well. Since our last update on the 25^th November, we  have seen increased cases demanding heightened attention and concerted efforts.

From October, 2023  to date, we have recorded a total of 1,385 cases in Lusaka Province with 36 deaths. Nationally, we note 2,270 cumulative cases with 52 lives lost  since 26^th January, 2023. Each number represents a life, a family, and a community affected by this devastating waterborne illness. In Lusaka province, we have cases in Lusaka, Luangwa, Chongwe and Chilanga districts. As of 13^th December, Eastern Province, has reported cases from Vubwi (1)  and Petauke (2).  The  two cases from Petauke are pending laboratory confirmation.

In admission currently we have 90 cases in the following facilities Chilenje (1), Kanyama (29), Chawama (13), Matero (10), Kalingalinga (9), Mutendere (4), Bauleni (3), Chelstone (1), Chipata Cholera Treatment Center (3), Ngwerere  in Chongwe (6), Tubalange in Chilanga (8), Vubwi district hospital (1), Minga mission hospital (1) and Nkwewankwa mini hospital (1).

 

Members of the Press, Ladies and Gentlemen,

Let me get into mechanisms we have in place in efforts to control an extension of the cholera outbreak.

1. Multisectoral Coordination

The Government of the Republic of Zambia continues to work with multiple local and international stakeholders to ensure targeted and timely response activities. Assuring you of the multisectoral approach to the cholera outbreak response, I have here with me my fellow Ministers from the Ministry of Local Government and Rural Development and the Ministry of Water Development and Sanitation.

Let me emphasize that the biggest stakeholder in cholera prevention and control is you the general public. The game changer in our efforts to create cholera-free communities, is each of us taking collective action and making choices to treat our water. This should be through boiling or using chlorine, to wash our hands before eating and after using the toilet. You further need to seek care early if you or your loved ones have diarrhoea.

2. Early Identification of cholera cases

 It is important that we all understand that during an outbreak  we have definitions we use to help us appropriately manage patients.  A “suspected cholera case” is anyone who develops acute watery diarrhoea. This is a person of any age, experiencing three or more episodes within a 24-hour period and may be with or without vomiting. This means we should not ignore any watery diarrhoea. As long as someone has 3 episodes in a single day they need to seek urgent care from their nearest facility, because cholera kills within hours. Early identification of cases helps us to isolate patients thereby reducing spread to others. It also allows our health workers to move into affected communities with specific preventive measures.

3. Provision of chlorine in affected communities

Our teams of health workers are on hand to trace homes of contacts in order to offer more information. They further provide chlorine for treating household water and disinfection services where required. Again, this we can only do well if cases or suspects are identified early; therefore, I urge the members of the public to take heed.

 

4. Heightened alert and activated cholera treatment centers

We have established cholera treatment centers and facilities across Lusaka to carter for isolation and effective treatment that cholera response requires. The health teams have been specifically trained to handle cases, and all our treatment facilities are supplied with needed fluids and medications.

Let me reiterate the importance of seeking medical attention early if you have diarrhea. Treatment is effective and saves life. I wish to remind you that not so long ago, in his opening remarks at the Conference of Public Health in Africa, our Republican President, His Excellency Mr. Hakainde Hichilema said that “No one should die of Cholera”. We remain aligned to this call hence our accelerated response.

I cannot overemphasise the need for all of us to work together towards this common goal for a cholera-free Zambia.

 

Members of the Press, Country Men and Women,

Stigma including self-stigma have led to persons infected attempting to treat themselves at home. This often results in severe disease and even death. We therefore must focus on Reducing Stigma. It is crucial to dispel the stigma surrounding cholera. This disease does not discriminate, and we must stand together to support those affected. Stigmatizing individuals only hinders our collective efforts to control the outbreak. Compassion and understanding are our greatest allies in the fight against cholera. I urge each and every one of you to remain vigilant and prioritize your health and the health of your loved ones.

Members of the Press, Country Men and Women,

I wish to emphasise the importance of good health seeking behaviour, which includes early access to health care facilities. As one is taken to the healthcare facility, they must be given Oral Rehydration Solution (ORS). Oral Rehydration Solution (ORS) was designed especially for cholera as it helps to replace the fluids and salts in the body that are lost through this profound diarrhoea.

We have also put in the affected communities, oral rehydration points (ORPs). These are community-based facilities that provide lifesaving therapy to our patients. They are manned by our community health workers to ensure that this life saving care is as close to the people as possible. They serve as an intermediate point of care for patient access prior to admission to the Cholera Treatment Unit so that we prevent deaths from dehydration and reduce the spread of the disease through health information and education.

These Oral Rehydration Points are an important part of the response to cholera. We would like to see more partners coming on board to help set up more of these points across the city. We are also actively setting up additional cholera treatment units and treatment centres, and providing decentralized care within each subdistrict.

 

Members of the Press, Country Men and Women,

I must announce here that our health sector partners have provided over K5.6 million worth of liquid and granular chlorine to the affected communities across the country and other support related to the response.

We are also hopeful that as soon as we access cholera vaccines, we will mount a campaign in Lusaka. Vaccines have tremendously helped in mitigating previous outbreaks. However, we have challenges of availability at the global level. We are trying our best to source these.

I must further stress that the prevention of cholera and other water-borne diseases really does not lie within the health sector. Our people need access to safe drinking water and safe disposal of human waste. While we put in immediate measures to control the current outbreak, I do acknowledge that defeating cholera is not only about immediate responses but also about long-term solutions. I extend my gratitude to my esteemed counterparts, the Minister of Water Development and Sanitation and the Minister of Local Government and Rural Development, for their unwavering commitment during this outbreak and beyond. We all want to achieve cholera elimination once and for all.

Members of the Press, Country Men and Women,

Investment in Water, Sanitation, and Hygiene (WASH) is not just a necessity; it is our pathway to a cholera-free Zambia. Together, we must work towards sustainable infrastructure that ensures clean water for all. If we do not act now to end cholera, the high costs of fighting cholera outbreaks will continue to restrain our ability to free up resources for development.

Members of the Press, Country Men and Women,

Emergency response remains costly and therefore lasting solutions even if long-term in nature need to be put in place. Globally, cholera is estimated to cost an average of K1,500 per person or $26 billion each year. This is due to costs related to emergency response, lost productivity, and loss of life. These estimates do not include the indirect economic and social consequences related to cholera. We have seen that large-scale cholera outbreaks can reduce national Gross Domestic Products (GDP) by as much as 2.5%.

The cost-benefit modelling for cholera control efforts in Zambia show that every K25 invested in long term improvements in WASH will result in K700 savings beyond the outbreak.

Allow me here to suggest that we utilise avenues such as the Constituency Development Fund (CDF) to improve WASH in the affected and at high risk communities. As it stands, over 10% of Zambia’s population (2 million people) reside in 20 hotspots and 13 high-risk districts across peri-urban areas with poor WASH facilities. 13 of these 20 hotspots have had outbreaks this year. As you can see, investing in cholera control has direct health and wellbeing benefits, and will invariably yield economic gains for the country in the long run.

Members of the Press, Country Men and Women,

We continue to rally behind the Call to Action, that is, To Kick Out Cholera from our country, region and indeed globally. It must start with us. We must be quick to remember lessons from the past outbreak of 2017/2018 that similarly started in October and ended in May the following year, with over 6,000 cases and 50 deaths. The rains that are now upon us is one of the key factors that may lead to the amplification of this current outbreak. In addition,  population growth, migration, and climate change have contributed.

 

Members of the Press, Country Men and Women,

I am seizing this moment to formally request a comprehensive report from the Permanent Secretaries of the National Disaster Coordinating Committee. This report should encompass recommendations directed towards the Council of Ministers National Disaster Coordinating Committee, focusing on enhancing our response to the current cholera outbreak.

Simultaneously, we are initiating the reactivation of the National Epidemic Preparedness Committee. This committee is scheduled to convene within the next week. I extend a call to action to all stakeholders, urging your active participation and collaboration with the government. Together, let us work to ensure the effective control of the cholera outbreak.

Members of the Press, Country Men and Women,

Today, I issue a rallying call to each Zambian: Let us unite to “Kick Out Cholera.”  Allow me to re-iterate the preventive measures and “3C’s to Kick out Cholera”:

1. Clean Water: Drink and use clean and safe water to brush your teeth, wash and prepare food, as well as when making ice or beverages. Water can be made safe by either boiling it or adding chlorine.
2. 2. Clean Hands: Wash your hands often with soap and safe water before, during, and after preparing food. Further, wash your hands often with soap and safe water before, during, and after using the toilet.
3. Early Care: Seek care early for you and your loved ones at the earliest signs of diarrhea, even before one develops dehydration. This can be at an oral rehydration point in your community or your nearest health facility/ cholera treatment unit.

This Government, through the leadership of our Republican President His Excellency Mr. Hakainde Hichilema, attaches great importance to securing the health of our people and the nation at large. As the Global Cholera Champion, he is looking on each of us to ensure  that we quickly end this outbreak, and achieve cholera control as a country.

May we emerge from this stronger, healthier, and more resilient.

Thank you and God Bless you

(Signed)

Honorable Sylvia T. Masebo, MP

Minister of Health