With Southern and Eastern Africa fighting a protracted cholera outbreak that has now spread to more than 16 countries, reports suggest that vaccine stocks have run out in the region. Over 230,000 cases and 4,000 deaths have been recorded from the infectious disease since the beginning of 2023, with children and adolescents accounting for up to 52 percent of cases in some countries. As governments and charities battle to bring the situation under control, the lack of vaccines means it is time to consider alternatives.
An acute diarrheal illness caused by infection of the intestine with Vibrio cholerae bacteria, people can get sick with cholera after consuming contaminated food or water. Primarily affecting areas with inadequate access to safe water and basic sanitation, cholera is essentially a disease of poverty and can kill within hours if left untreated. Estimates suggest there are between 1.3 and 4.0 million cases worldwide each year, and 21,000 to 143,000 deaths.
The latest outbreak is particularly severe in Zimbabwe, where there has already been over 25,000 cases and 470 deaths. In its attempt to limit the spread of the disease the country’s government has banned large gatherings, increased surveillance at ports of entry, and advised people against shaking hands. Water shortages and poor sanitation systems are commonplace in Zimbabwe, a situation which is inevitably fueling the problem.
Paying proper attention to nutrition could go a long way towards reducing the death toll. A double-blind, randomized controlled trial conducted at a hospital in Bangladesh has demonstrated that supplementing with 30 mg of zinc per day significantly reduces the duration of severe diarrhea in children with cholera. The researchers specifically recommend that children suffering from cholera should be given zinc supplements to reduce the disease’s duration and severity.
Other micronutrients which should be considered include vitamin D, which has an antimicrobial effect against the cholera bacteria; vitamin A, which has been shown to reduce morbidity from diarrhea in children; and vitamin C, low levels of which are associated with cholera infection in infants.
Once the current outbreak is brought under control, the focus should shift to preventing future ones. Here, the approach we are taking in our Movement of Life Zimbabwe project can act as a blueprint. Through supporting the development of micronutrient-rich fruit and vegetable gardens in schools and communities, we are simultaneously improving the health of the project participants and strengthening their immune systems.
Any surplus produce produced through the gardening project can be sold by the participants, thus helping improve the economic status of themselves and their communities. This aspect is particularly crucial, as cholera cannot be eradicated without addressing the fact that it is essentially a disease of poverty.
As the old saying goes, one definition of insanity is doing the same thing repeatedly and expecting a different result. In order for cholera to finally be eradicated from the African continent, it is necessary to address its root causes. Regardless of whether they are available or not, vaccinations alone are not enough.
