As cholera remains a concern in the region, United Nations Children’s Fund (UNICEF) and partners are working to support vulnerable children and families

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Thirteen countries in Eastern and Southern Africa are currently responding to cholera, most recently Comoros, Zimbabwe and Zambia. In some countries, 52 per cent of all cases are children under 15 years, with children under 5 accounting for approximately 40 per cent of deaths and 30 per cent of cases.

In addition to large-scale national cholera vaccination campaigns led by governments, in collaboration with UNICEF, the World Health Organization (WHO) and partners, supported by dedicated community-based volunteers and health workers - UNICEF is working with governments and local partners to ensure that children’s learning is not interrupted, and they have continued access to clean water and sanitation facilities, health supplies and medical products. UNICEF is also providing support to further strengthen the capacity of community-based volunteers, including young people and health workers, to reduce the risks of future outbreaks.

The preparedness and response that UNICEF has been able to provide to date would not have been possible without the generous and timely support of its partners. For UNICEF to scale up and respond effectively and equitably based on need, flexible resources will play a critical role.

As part of its regional response to the cholera outbreaks:

• UNICEF is collaborating with WHO, Africa CDC, governments, and other partners to coordinate cholera response at regional and country levels. UNICEF is the co-lead for community protection which includes water, sanitation, and hygiene (WASH) and risk communication and community engagement (RCCE) for behavior change.
• UNICEF has provided emergency health, water and sanitation supplies as well as medical products including cholera treatment kits and equipment to establish cholera treatment facilities. More than 8.3. million have been reached with critical water, sanitation, and hygiene supplies.
• UNICEF has facilitated the delivery of over 26 million OCV doses to eight priority countries with high cholera burden in the region: Ethiopia, Kenya, Malawi, Mozambique, Somalia, South Sudan, Zambia and Zimbabwe.
• In collaboration with WHO and partners, UNICEF has supported training frontline and community health workers on case management, WASH as well as infection prevention and control in treatment facilities.
• UNICEF reached 10 million people with messages on health and hygiene measures to prevent cholera and the importance of seeking medical treatment early, particularly for children.
• UNICEF continues to advocate for children’s learning to remain uninterrupted and for the implementation of protective measures in schools.

Country updates:

In Zimbabwe, UNICEF is supporting the Ministry of Health and Child Care to conduct single dose oral cholera vaccination (OCV) campaigns targeting 2.3 million people over 1 year in 24 high risk districts throughout the country. The roll-out of the OCV campaign in Zimbabwe is part of the multi-sectoral cholera response led by the Government and supported by UNICEF and partners in affected areas, prioritising improved support and treatment to people infected by cholera, securing access to safe water and sanitation, and disseminating messages on cholera prevention and treatment.

In Zambia, UNICEF and WHO facilitated the delivery of 1.7 million doses of OCV to supplement in-country stocks, for a reactive vaccination campaign in selected high-burden cholera hotspots in five districts of Lusaka Province. About 99 per cent of the target population have been vaccinated under the single OCV dose regimen, which includes 453,607 children 12 to 59 months old (24 per cent) and 602,711 aged 5 to 14 years (32 per cent), representing 56 per cent of the target population vaccinated. In the past two weeks, the number of new cases of cholera recorded reduced by over 50%, from over 400 cases reported daily on 22 January 2024 to less than 150 on 12 February 2024.

In Mozambique, UNICEF is implementing a large-scale response to what has become the country’s largest and longest-lasting cholera outbreak in recent history, with 45,000 cholera cases reported since September 2022. UNICEF’s response includes provision of water, sanitation and hygiene services, and infection prevention and control services delivered through 44 cholera treatment centres, as well as focusing on awareness and prevention. In coordination with WHO and Medecins Sans Frontieres (MSF), UNICEF is providing support for cholera case management, delivering materials and supplies for use in treatment centres and locations where people receive oral rehydration treatment, and funding medical training and monitoring of health staff. In January 2024, UNICEF supported the Ministry of Health to carry out a cholera vaccination campaign, reaching 2.2 million people in nine of the country’s worst affected districts. This has proven effective in controlling case numbers, and plans are now underway for preventive vaccination campaigns in hotspot districts, part of a national plan to eliminate cholera.

In Somalia with 18,000 cholera cases, half of them children, which have claimed 49 lives, UNICEF is providing safe drinking water and handwashing facilities at household and community level, educating communities on personal hygiene and safe handling of food, and strengthening the capacity of health workers, including community health workers, to manage cholera cases.

In Malawi, UNICEF has adopted an integrated approach to reduce transmission and cases, particularly among children.  UNICEF has provided the Ministry of Health with emergency health supplies and medical products to treat more than 34,200 cases. Together with WHO, UNICEF also supported OCV campaigns targeting 6.2 million people in the hardest hit areas.  In addition, 12,000 health workers were trained in case management, surveillance and infection control and 3.1 million people have gained access to safe water through UNICEF-supported interventions. These actions have drastically reduced transmission in the country, particularly among children.

In Ethiopia, nearly 30,000 cases of cholera were reported in 2023. As a result, 138 Cholera treatment centers were established to treat infected patients including women and children. In addition, nearly 22 million people were reached with key message on hygiene practices focusing on disease outbreaks to mitigate the cholera endemic and stop its spread.
Distributed by APO Group on behalf of United Nations Children’s Fund (UNICEF).