The Government of Malawi declared cholera as a public health emergency on 5^th December 2022 and appealed for additional support from partners. In collaboration with government and partners, WHO responded, and the cholera threat was put under control. By August 2023 the government of Malawi declared it as no longer a public health risk. Despite the declaration of cholera as no longer a public health emergency, a few districts continued to report sporadic cases every week. This trend required immediate response to halt the escalation and community transmission.

“As WHO Malawi Country Office, we had to come in and upon being requested by the Ministry of Health (MOH) we approved the sum of MK66,251,000.00 from the German Grant to support districts considered more susceptible to cholera in the country. The support was to enable the districts implement cholera preparedness and prevention activities to halt the escalation of the disease in the communities.”  Explained, Dr Neema Kimambo, WHO Country Representative for Malawi. 

The supported districts included Lilongwe, Blantyre, Chikwawa, Nsanje, Thyolo, Mulanje and Ntcheu. To attain the expected results implementation was led by Health Promotion and RCCE teams for the districts respectively. Objectively, the districts were expected to increase cholera awareness and dispel rumours and misinformation through community engagement and risk communication; promote household and community hygiene, good sanitation and increase cholera prevention awareness and finally promote awareness and knowledge in handling and management of cholera cases in at risk communities.

The following activities were implemented with support from WHO Malawi.

1. Engagement sessions with the local and religious leaders in communities
2. Engagement sessions with market committee members in cities and townships
3. Persuasive Activity Storming of cholera hotspots, like markets, trading Centres and Schools
4. Mobile Van Announcements and interactive audio-visual shows in selected busy roads, densely populated villages, and townships
5. Coordination meetings for district level Health Promotion and RCCE Technical Working Groups (TWGs)  

Through implementation of these activities, we have been able to reach 365 community leaders 227,610 community members, 122 market committee members and 89 district level members of the Health Promotion and RCCE Technical Working Groups.

Through the community engagement interventions so far implemented, community leaders have been empowered to speak up and disseminate cholera prevention messages in their communities during community events and gatherings as testified by Mr Wellington Nkhoma, a community block leader in area 36, a cholera hotspot location in Lilongwe  

“As a community leader I am empowered and committed to cholera prevention in my area. I preach and communicate cholera prevention methods during community meetings, church functions, weddings and during funeral ceremonies.” Emphasized Nkhoma

Lilongwe district is one of the districts which accessed the support from WHO. Health Promotion Officer for the district Mr Richard Mvula acknowledges and appreciated the support.

“WHO Malawi Country Office has always been forthcoming to contribute efforts to our District Multisectoral Implementation Plan supporting cholera preparedness and prevention. It is through such support that Lilongwe as a district, has been able to contain cholera in the 2023/24 cholera season as we only registered 4 confirmed cases compared to the previous year when we had the cholera outbreak disaster with with 12,792 cases and 560 deaths”.  Explained Richard Mvula.

The implementation of cholera preparedness and prevention interventions by the cholera vulnerable districts as supported by WHO has been highly commended as they complemented government efforts of a multi sectoral approach in the response to cholera in Malawi. It is in recognition of these concerted efforts that a downward trend of cholera cases has been recorded in the 2023/24 cholera season.

Cholera cases and deaths from March 2022 – April 2024 (left), and November 2023 to April 2024 (right).

The support from WHO has strengthened capacities in respective districts to prevent, prepare and respond to cholera and other emergencies in a well-coordinated manner.