The Fight
Against Cholera

Situation at a glance, Malawi is experiencing a widespread cholera outbreak, with 36 943 cases and 1210 associated deaths reported from all 29 districts since 3 March 2022. This is the deadliest outbreak of cholera in the country’s history. Cholera has been endemic in Malawi since 1998 with seasonal outbreaks reported during the rainy season (November through May). However, the current outbreak has extended through the dry season, with cases being reported since March 2022. In light of the ongoing rainy season, wide geographical spread, and a consistently high case fatality rate (CFR) of above 3%, the ongoing cholera outbreak was declared a public health emergency by the Malawi government on 5 December 2022. Currently, the large geographic spread and the high number of reported cases in the country are stretching all capacity to respond to the outbreak, increasing the risk of serious public health impact. The outbreak in Malawi is occurring against a backdrop of a surge in cholera outbreaks globally, which has constrained the availability of vaccines, tests, and treatments. With a sharp increase of cases seen over the last month, fears are that the outbreak will continue to worsen without strong interventions

Public health response Emergency response activities are being conducted by the Ministry of Health, COSA and other partners since the declaration of the outbreak in March 2022. Coordination and response: The ongoing cholera outbreak has been declared a public health emergency by government of Malawi on 05 December 2022. This led to the incorporation of cholera into its Presidential Taskforce on Coronavirus Disease, to be responsible for coordination of the outbreak response. The Presidential Task Force members on COVID-19 and cholera have been visiting all affected district to understand the situation. A costed national cholera response plan to manage the outbreak was drafted and is being updated regularly. WHO and other partners are supporting the implementation of various activities aligned with the plan. National- and district-level emergency operation centres (EOCs) have been operationalized to coordinate the multisectoral response with other partners. Multisectoral coordination group for cholera response has been established in the affected districts. The National Incident Management Team (IMT) continues to coordinate technical response to the outbreak. The IMT meets twice a week at the Public Health Emergency Operations Centre (PHEOC) in Lilongwe.