Time to tame cholera spread

Time to tame cholera spread

Cholera, an acute intestinal infection that spreads through food and water contaminated with the bacterium Vibrio cholerae, often from faeces, is fast spreading in Nigeria. According to authorities, more than 63 lives have been lost to cholera and 2,102 cases as confirmed by the Nigeria Centre for Disease Control and Prevention, NCDC in more than 33 states across the country.

Globally, the World Health Organisation (WHO) has reported that ‘’researchers have estimated that every year, there are 1.3 million to 4.0 million cases of cholera, and 21 000 to 143 000 deaths worldwide’’. What makes the scenario scarier is the announcement by the WHO that there are presently no enough vaccines to effectively tackle the ongoing resurgence of cholera, which it classified as a grade three emergency in January 2023.

“The global stockpile of Oral Cholera Vaccines (OCV) was depleted until early March but exceeded the emergency target of five million doses in early June for the first time in 2024. As of June 10, 2024, the stockpile has 6.2 million doses. However, demand for the vaccine continues to outpace supply. Since January 2023, 92 million OCV doses were requested by 16 countries, nearly double the 49 million doses produced during this period,” it said.

It added that it was working with other partners such as the UN Children’s Fund (UNICEF), to use resources to find long-term solutions for cholera.

Already, the WHO said, “The recent outbreaks have also been more deadly, with case fatality rates being the highest recorded in over a decade.”

Nigeria has been placed on high risk for increased cholera transmission and impact due to the rainy season. On Tuesday, June 25, the Coordinating Minister of Health and Social Welfare, Professor Muhammad Ali Pate announced that President Bola Tinubu has directed the setting up of an inter-ministerial committee to oversee the cholera emergency operation centre being operated by the National Centre For Disease Control (NCDC). “The president directed that cabinet committee be set up to oversee what the emergency operation centre led by NCDC is doing and for the resources to be provided and complemented by the state governments.’’

Lagos State is the epicenter and so far the most impacted with more than 29 fatalities and 579 suspected cases as reported to the state Ministry of Health. The Special Adviser to Lagos State Governor on Health, Dr. Kemi Ogunyemi, had listed Lagos Island, Kosofe, Ikorodu and Eti Osa as areas recording the highest numbers.

She said: “The Ministry of Health, in collaboration with the  Ministry of Environment and its agency, the Lagos State Environmental Protection Agency (LASEPA), continues to collect samples of water sources, food, and beverages to identify the source of contamination.”

But there is need for a more coordinated national response as cases have been reported in many other states, especially those with high population density and slums. Affected states so far include Bayelsa, Lagos, Zamfara, Abia, Bauchi, Cross River, Ebonyi, Katsina, Delta, Imo, Nasarawa, Ondo, Kano, Niger, and Osun. These 15 states account for more than 80 per cent of the cases currently, Director-General of the NCDC, Dr Jide Idris, said.

The frequent outbreak of cholera in the country is, in our view, a failure of the public health system. In the past, officials routinely supervise sanitation events for residents in towns and villages to ensure that the environment is kept clean at all times. This important effort is no longer common and needs to be reintroduced and reinvigorated, especially in cholera-prone areas of the country. Local governments, which are constitutionally charged with this responsibility, must take the task very seriously once again. When introduced, local governments must make sure it works effectively as it used to be.

It is, therefore, necessary for the federal, state and local governments to work together to pass the right message and plan an effective response to this health crisis. Citizens must be sensitised on the importance of vigilance, practicing good hand hygiene, avoiding overcrowding, and participating in community sanitation activities to stop the spread of cholera, because government and its agencies cannot do it alone.

Other simple preventative measures for cholera such as oral rehydration therapy should be encouraged through educating the public on its effectiveness. This method can be published in small pamphlets and distributed free in both public and private hospitals

All the three tiers of government in Nigeria must treat the current cholera outbreak as a serious case deserving all the necessary response available to them. As experts have said, cholera can be prevented with safe water and sanitation. Although it can kill within hours when not treated, immediate access to treatment saves lives.

There is no doubt that good health begins with a clean environment.