Building Better Infrastructure to avoid the Economic Cost of Cholera Outbreaks in Zambia

A cholera outbreak was officially declared by the Minister of Health of Zambia in October 2017 in Lusaka, the countries capital.

Cholera is highly contagious diarrhoeal disease that if left untreated can kill within hours. Clean water and sanitation are essential to controlling the transmission of the disease that occurs through the ingestion of water or food that is contaminated by the bacterium Vibrio cholerae. Since the official declaration of the outbreak and up until 10 January 2018, the Ministry of Health reported 2672 cases. Lusaka alone accounts for 2,558 cases. 63 deaths were recorded countrywide, 58 of which were in Lusaka. The main affected areas in Lusaka are densely populated and low income with poor water and sanitation infrastructure. On 27 February 2018, the Ministry of Health recorded 18 new cases of cholera. Based on these figures less people are contracting and dying from cholera.

The Zambian government has took several measures to prevent the spread of the epidemic.  Children who were due to return to the classroom in the week of January 8, 2018 only started the school year at the end of January.  Public gatherings (funerals, meetings, church gatherings etc) were for a period banned, street vending has been outlawed, businesses whose food was found to be contaminated were closed and night clubs operating hours were reduced. The army is patrolling the streets to ensure that the public complies with these strict regulations. Traders, who have temporarily lost their livelihood because of these measures rioted and understandably so as the epidemic is avoidable if appropriate measures are taken to improve water and sanitation infrastructure and to sensitise the public on hygiene practices.

The treatment of any disease comes at a cost to society beyond the individual who is ill. Through disease, the economy can incur grave losses. Malaria for example, affects all individuals who enter and inhabit a particular area. This may for instance affect the number of tourists that visit the country hence blocking income that could be generated. The direct and indirect economic costs of cholera are therefore worth noting. Direct costs are obviously those attached to the treatment of the disease. This includes sending military personnel to clean the city of Lusaka, hospital and medical professional costs, a loss of taxes for the Zambia Revenue Authority (ZRA) from the closure of businesses that pay taxes, the cost of community sensitisation, loss of income by the sick individual and the cost incurred by family members who are taking care of those who have cholera.  Indirect costs occur through mortality leading to one losing economically productive years of life. Additionally, with Zambia aiming to diversity it economy beyond copper production through agriculture, the cholera epidemic renders exports from Zambia unattractive as they may be deemed contaminated. Similar to economic diversification, Zambia which has wildlife and tourist attractions such as the Victoria Falls may be unattractive to tourists.

All in all, cholera is an expensive disease that comes with economic repercussions. The epidemic occurs year in and year out in countries beyond Zambia such as Tanzania and the Democratic Republic of Congo (DRC) yet states still do not have a handle on it.  It must be noted that poor socio-economic developmental capacity predisposes countries such as Zambia to cholera outbreaks. The basic cause of poor people living in overcrowded and unsanitary conditions with poor public health monitoring and limited access to healthcare means that there will be an outbreak each year for years to come.

Given the high economic cost that a cholera outbreak brings with it, and that the channels of cholera transmission and spread are widely known, policy makers need to exercise increased care in the future to curb the disease and its spread.

The bottom line is that cholera is preventable. With better water and sanitation infrastructure future outbreaks can be prevented. Resources used to carry out emergency measures could be used to build cleaner and more sanitary infrastructure. The state needs to pay attention and listen to the needs of those in epicenters. It is not right to only put out fires once the issue escalates.


Featured image | cholera prevention sign board | SuSanA Secretariat : flickr

The views and opinions expressed in this article are those of the author and do not necessarily reflect the views of The Best of Africa.

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2 thoughts on “Building Better Infrastructure to avoid the Economic Cost of Cholera Outbreaks in Zambia

  1. Very true. But I shudder to think why we are not proactive and there seems that the is no continuity. I live in a quiet area of Kitwe and for one week we have had no garbage collected by our service provider in spite of us spending money buying the disposal bags from them. Now stray dogs are ripping open the plastic bags exposing us to the filth.

    1. This is true aswell. Service providers and individuals do play a role in not taking care of the environment we live in.

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