Cholera: Need for Collaboration to End Cross-border Transmission
By Gift Briton
In light of the global shortage of cholera vaccines, the World Health Organization(WHO) has urged countries to ramp up cross-border and multi-sectoral collaboration and surveillance to increase access to clean water, sanitation and hygiene to the affected populations in order to end the ongoing cholera outbreak in Africa.
According to Dr. Patrick Ramadhan, WHO Africa’s Incident Manager for Regional Cholera Response, although there is a moderate risk of cholera transmission due to cross-border movements, countries at risk are urged to put in place emergency surveillance and increase cross-border collaboration to enable prompt detection and response to the disease.
In Africa, the cholera outbreak has been reported in 10 countries including Somalia, Malawi, Mozambique, Zambia, Cameroon, Nigeria, DRC, Burundi, Kenya, and Ethiopia. However, outbreaks in some of these countries are linked to the cross-border transmission.
In the horn of Africa, the outbreak in Kenya, Somalia, and Ethiopia are driven by the prolonged and harsh drought which causes malnutrition among the affected people and limits their access to clean water. This, in turn, increases both in and out-country movement of people between these countries thereby increasing the transmission rate.
Also, in southern Africa, the outbreak in Mozambique and Zambia is linked to the cross-border movement of people.
“Countries should put in place effective surveillance for prompt detection and rapid response so that any small outbreak that is identified is contained immediately,” Dr. Ramadhan noted during a WHO online press briefing.
“We have also noticed that the cross-border transmission that is happening particularly in the southern region and also between Somalia and Kenya and we encourage countries to work on cross-border collaboration and have joint surveillance and interventions so that we can be able to contain those outbreaks.”
He also emphasized on the importance of multi-sectoral response and solution collaboration in ending the outbreak, adding that both countries reporting outbreaks and countries at risk should work on multi-sectoral collaboration to increase access to clean water and sanitation facilities to mitigate the risk of cholera.
“It is really important for governments to prioritize and invest in interventions that increase the availability of safe drinking water and hygiene facilities and put their readiness and surveillance system in alert mode,” Dr. Ramadhan.
According to him, surveillance is very critical and should be implemented at different levels including surveillance between and within countries to survey movements of people, putting in place officers that ensure the safety of food imported to the country, ensuring that health workers are trained and equipped with tools to be able to detect cholera cases.
“Community-based surveillance is very important so that we are able to pick what is happening in the community and investigate. Water quality surveillance to test different water sources and identity the contaminated sources and working with colleagues in the water sector to be able to decontaminate the water and inform people that this water is contaminated and give them as well as employing community volunteers to move around and survey cases when a case has been confirmed,” he noted.