The outbreak in Mozambique is part of a larger regional trend, with neighbouring Malawi facing the deadliest cholera outbreak in its history, WHO said

Mozambique is currently grappling with a rapidly growing cholera outbreak that has spread to six of the country’s 11 provinces. The outbreak, which began in September 2022, has been exacerbated by heavy rainfall in recent weeks, with fears that the situation may worsen if the rains continue.

In February, the World Health Organization (WHO) reported that a total of 5,237 suspected cases and 37 deaths had been recorded, with a Case Fatality Ratio (CFR) of 0.7 percent. Of the at least 182 cases tested, 99 cases (54 percent) were laboratory confirmed for cholera. The six provinces currently affected by the outbreak are all flood-prone areas, with many districts experiencing cholera cases for the first time in over five years, leading to limited response capacity.

Cholera cases reported by week and province in Mozambique from 14 September 2022 to 19 February 2023^*

According to the WHO, the outbreak in Mozambique is part of a larger regional trend, with neighbouring Malawi facing the deadliest cholera outbreak in its history. There is a high risk of further disease spread both within Mozambique and across borders due to the frequent cross-border movement in the region.

The situation is further complicated by inadequate access to safe drinking water, particularly in areas already challenged by poor hygiene and sanitation. In addition, the country’s health system is struggling to cope with multiple emergencies, including the ongoing COVID-19 pandemic, conflict in the northern region, and a recent wave of floods.

The WHO and other organisations have been working with the Mozambican government to contain the outbreak through measures such as increasing access to safe water sources and implementing cholera treatment centres. However, the heavy rains and limited response capacity in some areas have made the situation challenging.

The situation is particularly dire in Niassa province, where eight districts have reported 2,525 cases and 16 deaths (CFR 0.6 percent). Most of the affected districts in Niassa, as well as other provinces, have not reported cholera cases in over five years, leading to a shortage of experienced health professionals to respond to the outbreak.

The WHO has called for urgent action to prevent the further spread of cholera in Mozambique, including increased support for water and sanitation services, strengthening disease surveillance and response systems, and improving access to life-saving treatment for those affected.

The cholera outbreak in Mozambique is a stark reminder of the urgent need for investment in water and sanitation infrastructure in the country and the wider region. Without these critical services, communities are at heightened risk of deadly waterborne diseases such as cholera, particularly in the face of climate change-induced extreme weather events such as heavy rainfall and floods.

In the short term, urgent action is needed to contain the current outbreak and prevent further spread. In the long term, sustained investment in water and sanitation infrastructure, as well as efforts to address underlying poverty and inequality, are critical to reducing the risk of future outbreaks and ensuring the health and well-being of all Mozambicans.

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