Bill & Melinda Gates Foundation

Cholera in Haiti, Africa and Beyond

October 17, 2013

Cholera is a disease that affects the most marginalized and impoverished people on our planet. But unless an outbreak is explosive (as it has been in Haiti) it is often ignored. Why should you care? For one, it’s still a major cause of illness and death of children in poor countries along with other “diarrheal diseases” (like rotavirus) and that’s simply unfair. Another reason is that working to improve conditions (including better water, sanitation and hygiene) that cause cholera will impact a wide variety of other diseases that also affect poor communities including polio, typhoid, Guinea worm, Hepatitis A, Hepatitis E, and more.

The annual number of cases and deaths due to cholera is acknowledged to be drastically under reported and yet it is still too high. Each death is a person with a name, a story, and loved ones left grieving.

Cholera is in the news because progress is being made. It’s been widely discussed (recently there were two journals that devoted ample space to cholera in Africa and Haiti) but there continue to be outbreaks in different parts of the world.


A busy West African market in Guinea. Photo © Helen Matzger

What’s the latest? In terms of cholera outbreaks in Africa and Haiti, we know that:
  • In Africa, more than 20 countries are continuously reporting cholera cases. 2012 saw large epidemics in the Democratic Republic of Congo, Sierra Leone, Ghana, Guinea, Uganda and Niger with high rates of death.
  • There are two main patterns for cholera – (1) occurring continuously with outbreaks often during the rainy season, and (2) short bursts of unpredictable outbreaks. These patterns have implications for how we should think about preventing and preparing for cholera cases.
  • Haiti reports nearly half the world cases of cholera and is now considered home to the largest outbreak in modern times.
  • In Haiti, only 42 percent of households have access to clean water.

But it’s important to understand that there are ways to protect people in low-income countries from getting cholera. They range from clean water and safe sanitation to the use of vaccines.

  • There is documented feasibility of the use of an oral cholera vaccine in both Guinea and Haiti that suggest that future use of vaccines combined with water and sanitation efforts can be an effective intervention.
  • The vaccine has recently been shown to protect against cholera for five years.

The morgue at a cholera treatment center in Guinea. Photo © Helen Matzger

  • Surveillance can help communities plan and prepare for outbreaks and target interventions. However, adequate widespread surveillance is still sorely lacking

Cholera is a disease that has not been adequately addressed. Men, women and children are needlessly dying from diarrhea. This doesn’t have to happen if we raise awareness and help spread information about how to protect against cholera. Share the message. 

 
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