Opening Statement, Press Conference, 2 March 2023

Submetido por kiawoinr@who.int a

Remarks by Dr Matshidiso Moeti, WHO Regional Director for Africa

I wish a good day, bonjour, bom dia to all the journalists joining us for this press conference.

Today I’d like to provide an update on the cholera outbreaks in the region and highlight the health impacts of cyclones in southern Africa.

I am delighted to be joined by Professor Zely Arivelo Randriamanantany, the Minister of Public Health, Republic of Madagascar.

Professor Randriamanantany is leading his government’s response to the health impacts of cyclones in Madagascar, which has faced two cyclones this year.

Bienvenue Monsieur le Ministre et merci. Thank you so much for having joined us.

In Africa, new cholera cases fell to 2880 in the week ending on 26 February, and this was a 37 or almost 40% decline compared with the week before when 4584 cases were recorded.

Twelve African countries are currently reporting cases, with South Africa, Tanzania and Zimbabwe being the latest to detect cholera cases. 

Lack of safe drinking water and also too much water, in the form of flooding, amplify the risk of cholera.

I returned from a mission to Mozambique last week, where I saw how cyclones can impact people’s health. 

And then, just after I left Mozambique, Tropical Cyclone Freddy, one of the longest-lasting systems in the southern hemisphere, hit Madagascar then swept through southern Mozambique with strong winds and high seas, threatening neighbouring parts of southern Africa. 

This is the second cyclone Madagascar has faced this year. In January, the country was hit by Cyclone Cheneso, which left more than 471 000 people without access to health services.

The Honourable Minister will discuss the ongoing health emergency response following the cyclones, I’m certain. 

In Malawi, which is experiencing its worst-ever cholera outbreak, increased rainfall is slowing outbreak control efforts in some areas, with response teams facing difficulty reaching needy people.

In Mozambique, 55 health facilities have been damaged or destroyed, and more than 43 000 people have been affected by Cyclone Freddy. The country has seen a sharp increase in cholera cases since December 2022 amid the ongoing rainy season.

Eastern Africa, for its part, has been affected by drought, which sends populations on the move in search of water and pasture, increasing the vulnerability to cholera outbreaks.

The worldwide spike in the outbreaks has prompted WHO to declare cholera a global Grade 3 emergency— meaning the highest in our internal WHO Emergency Response Framework.

Africa has had large outbreaks of cholera in the past. What is unusual is to have so many co-occurring and linked to major climactic events.

A shortage of the oral cholera vaccine on the global level has exacerbated the situation. As part of the International Coordinating Group on Vaccine Provision, we are stepping up our support to countries:

We’ve helped secure 3.4 million doses of the oral cholera vaccine for campaigns in Kenya, the Democratic Republic of Congo and Mozambique.

We are supporting countries to recruit short-term additional experts and staff to respond to cholera so that other essential services are not disrupted. In Malawi, as I speak, over 400 short-term staff have been recruited to support the running of cholera treatment centres.

These frontline health workers must be protected from attacks, as recently seen in Malawi, and we think these were due to false community perceptions of the outbreak.

With the Africa CDC as a key partner, we are convening a high-level ministerial meeting hosted by Malawi on cholera. The forum aims to revive commitments to end cholera outbreaks in Africa and strengthen cross-border collaboration for its control.

Over the past two months, in addition, 455 tons of critical cholera supplies, including Intravenous fluids, have been delivered to Malawi and Mozambique, and to support preparedness in Burundi, the Democratic Republic of the Congo, Ghana, Kenya, and Zambia. In addition, we’ve supplied some ambulances to Malawi to help with referrals of severe cholera cases.

Also, using imported and locally-sourced supplies in Malawi, our logistics team designed, made, and operationalized seven Cholera Treatment Facilities with 164 beds. Two additional facilities with a combined total of 50 beds are currently under construction. This will bring the total bed capacity that we provide to 214 and enable over 428 patients—based on two patients per bed—to be treated per week.

We’ve deeply appreciated the collaboration of various partners in these efforts.

Cholera, we understand, is a disease of inequity, driven mainly by inadequate access to safe, clean water and hygiene facilities and, of course, exacerbated by extreme weather events. The continent still has a high proportion of households with limited or no access to safe water and hygiene facilities.

Therefore, preventing cholera and many other epidemics doesn’t solely depend on the health sector. It requires investment in providing safe water and hygiene infrastructure, such as toilets. This multisectoral intervention demands collective action from several Government Ministries, local governments, municipal authorities, communities and partners.

So, I’d like to reiterate our call for a coordinated national and global response, including equitable access to the available and affordable tools to address cholera and other diseases across the continent.

Thank you very much indeed for joining us. Again, thank you, and welcome to the Honourable Minister from Madagascar, and I look forward to our discussions today.