Devex CheckUp: This distant crisis sparked Malawi’s cholera outbreak

Next week in New York, world leaders are expected to make commitments at the United Nations General Assembly on health and climate — two big issues that are closely intertwined.

By Jenny Lei Ravelo // 14 September 2023

Those connections became apparent in Pakistan’s massive floods worsened by climate change that fueled not just the country’s largest cholera outbreak, but also Malawi's worst cholera outbreak in history.

A group of researchers found strong evidence that links the two: The new cholera strain that circulated in Pakistan during the floods was the same one that caused the deadly outbreak in Malawi, killing over 1,760 people. It potentially reached Malawi via air travel. Someone from Pakistan already infected with the bacteria could have brought it to the country.

Malawi’s outbreak was amplified last November when the rainy season began and then intensified further during Cyclone Freddy this year. Flooding led to contamination of water sources and displacement of communities. This limited people’s access to clean water and sanitation, creating the perfect conditions for a cholera outbreak. It was only August when Malawi declared that cholera is no longer a national public health emergency.

This underscores the importance of genomic surveillance, which can help to alert public health officials when new strains arrive in their country in order to prepare, such as stocking up on oral rehydration salts and intravenous fluids, Tulio de Oliveira of Stellenbosch University in South Africa, tells my colleague Sara Jerving.

It’s often difficult to arrange for large shipments of these commodities quickly in an emergency, he says. And delays can result in lives lost.

Read: How Pakistan's massive floods sparked Malawi's record cholera outbreak

Manuscript: Genomic epidemiology of the cholera outbreak in Malawi 2022-2023

News date: 2023-09-14


Publication cited

Genomic epidemiology of the cholera outbreak in Malawi 2022-2023. Chabuka L, Choga WT, Mavian CN, Moir M, Tegally H, Wilkinson E, Naidoo Y, Inward R, Morgenstern C, Bhatt S, Wint WGR, Khan K, Bogoch II, Kraemer MUG, Baxter C, Tagliamonte M, Salemi M, Lessells RJ, Mitambo C, Chitatanga R, Bango JB, Chiwaula M, Chavula Y, Bukhu M, Manda H, Chitenje M, Malolo I, Mwanyongo A, Mvula B, Nyenje M, de Oliveira T, Kagoli M, medRxiv (2023),