By Alfred Nyakinda

More than 800,000 people in four districts affected by Cyclone Idai have been vaccinated against cholera in a six-day emergency campaign by the Ministry of Health in Mozambique.

The oral cholera vaccines, donated by the Global Alliance for Vaccines and Immunizations (Gavi), from the Global Cholera Vaccine Stockpile, arrived in Beira on Tuesday 2 April and, within 24 hours, began reaching people in need.

Mozambique man receiving vaccination
Photo credits: WHO/ M. Nieuwenhof

“From start to finish, this campaign was one of the fastest ever, thanks to experienced people at the Ministry of Health, who knew there was a high risk of a cholera outbreak and made a rapid request for the vaccines as soon as the cyclone hit,” says Dr Djamila Cabral, Head of the WHO office in Mozambique.

The highest risk districts- Beira, Dondo, Nhamatanda and Buzi- that lack access to water and sanitation facilities, were the recipients of the vaccine. Uptake was very high with a positive response from the community.

The campaign was supported by around 1200 community volunteers and partners including the World Health Organization (WHO), UNICEF, Médecins Sans Frontières (MSF), International Federation of the Red Cross and Red Crescent Societies (IFRC) and Save the Children.

“This campaign would not have been possible without the strong engagement of the local authorities and the communities themselves. The number of volunteers is impressive and, wherever they go, there has been very strong uptake of the vaccine,” said Dr Cabral.

The remainder of the nearly 900,000 doses of the vaccine supplied will be used for other at-risk communities that were not reached by the initial campaign. The floodwaters that had formed inland oceans have since receded, allowing help to reach those who had been cut off.

People develop protection against cholera aapproximately seven days after receiving the vaccine. One dose of this oral vaccine provides around 85 percent protection against cholera for 6 months.

“Controlling cholera in these areas will reduce the risk to the rest of the population because fewer people will be taking it back and forth into the wider community,” says WHO cholera vaccination expert, Kate Alberti.

According to the UN office for the coordination of humanitarian affairs, prior to the crisis only half of Mozambicans had access to an improved water supply and only one in five used improved sanitation facilities.

Damage from the cyclone has resulted in households losing access to safe sanitation, with latrines overflowing and homes destroyed. The hundreds of thousands seeking refuge in collective centres are living in congested conditions with limited or no access to safe water and sanitation.

The Ministry of Health declared a cholera outbreak on 27 March and, as of 8 April, had reported more than 3577 cases and six deaths. In addition to the vaccine, 12 cholera treatment centres, with 500-bed capacity, have been set up by the national authorities and international partners to serve the affected communities.

Dr Nazira Abdula, Minister of Health of Mozambique, acknowledged the great support of WHO and partners for the vaccination campaign. “It’s very difficult to roll out a campaign of this scope in only three days,” she said.

Partners are also supporting the local authorities to provide access to safe water and sanitation in settlements and communities across Sofala Province. In several parts of the province Cholera is endemic; meaning confirmed cholera cases resulting from local transmission have been detected in the last three years.

The cholera outbreak that developed post-Cyclone Idai acts as a reminder that sustainable access to safe water, sanitation, and hygiene (WASH) is the long-term solution to controlling cholera. Acknowledging that every case of cholera is preventable, the Global Task Force on Cholera Control is implementing a Cholera Global Roadmap to 2030, which calls upon development partners and donors to support countries to reduce cholera deaths by 90 percent by 2030.