Faced with cholera, which is progressing again at an alarming rate, the means exist. But resources are desperately lacking, the UN warns Friday, May 19: this "pandemic of the poor" threatens a billion people in 43 countries.

"There is a pandemic that is killing the poor before our eyes and we know exactly how to stop it, but we need more support and less inertia from the global community, because if we don't act now, it will get worse," Jerome Pfaffmann Zambruni, head of UNICEF's public health emergencies unit, warned Friday. at a press conference in Geneva.

"WHO estimates that one billion people in 43 countries are at risk of cholera," said his colleague Henry Gray, a World Health Organization (WHO) official in charge of fighting the scourge, which spreads like wildfire in the absence of adequate sanitation and clean water.

Poverty, conflict, climate change

Cholera causes diarrhoea and vomiting, and can be particularly dangerous for young children. The UN needs $640 million to fight the infectious disease, but said the longer it waits to increase the means to fight it, the worse the situation will become.

According to WHO, vaccination campaigns have been severely hampered. So far this year, 24 countries have reported cholera outbreaks, up from 15 in mid-May last year.

Countries that are not usually affected are now victims of cholera vibrio and the mortality rate far exceeds the usual 1%.

Henry Gray blamed the increase in cases on poverty, conflict, climate change and the displacement it causes, in very precarious conditions.

"With the increase in the number of countries affected by cholera, the resources available for prevention and care are more dispersed," he said.

Not enough vaccines available

The oral cholera vaccine is one example: more than 18 million doses have been requested this year, but only 8 million are available, forcing prevention campaigns to stop.

The WHO was also forced to recommend a single dose of vaccine instead of two to save more people, but at the risk of protecting them for less time.

"The future is bleak," Gray insisted. In total, WHO and UNICEF, working closely together to combat the bacteria, need $160 million and $480 million respectively over the next twelve months to respond in more than 40 countries.

"We know how to treat it. We know how to control it. It's not easy, but it's simple," said Jérôme Pfaffmann Zambruni. Although cholera can kill in a matter of hours, it can be treated with simple oral rehydration and antibiotics for more severe cases.

But many people do not have timely access to such treatment. Epidemics can be prevented by ensuring access to safe drinking water and improving surveillance. But the lack of funds for a rapid response will pay for in lives that could have been saved, Gray said.

"The overall solution is a long-term investment in wastewater infrastructure," he added. In the short term, the shortage of vaccines exacerbates the situation.

The product is not very attractive to manufacturers because there is no market in rich countries. It is currently manufactured between 2 and 3 million doses per month and the number of doses available could double by 2025 and then double again by 2027, but it still won't be enough.

Cholera cases have steadily declined over ten years, but the trend reversed in 2021. The most affected countries so far this year are Malawi and Mozambique.

Nine other countries are considered in "acute crisis": Burundi, Cameroon, the Democratic Republic of Congo, Ethiopia, Kenya, Somalia, Syria, Zambia and Zimbabwe.

With AFP

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