When cholera broke out in the Zambian capital of Lusaka in February 2016, it seemed like a disaster foretold. Around 1.2 million people live in crowded urban settlements prone to flooding and the spread of disease. That year, the rainy season arrived late, causing boreholes to dry up and pushing people to draw water from shallow wells. When the rains finally did come, floodwaters mixed with overflowing pit latrines, creating rivers and lakes of contaminated water across the settlements. This was the ideal environment for a large-scale cholera outbreak.
Faced with the threat of a major cholera epidemic, the Zambian Ministry of Health requested assistance from MSF to halt the spread of disease. Working with the World Health Organization (WHO), MSF helped plan a massive campaign aiming to vaccinate some half a million people in Lusaka. However, at the time, the global emergency stockpile of the oral cholera vaccine was too limited to provide such a large at-risk population with the standard two doses. MSF recommended providing a single dose of the vaccine to ensure maximum coverage immediately, and to deliver a second dose later when more supplies became available. Earlier evidence indicated that a single dose delivered to twice as many people would quickly maximize so-called “herd immunity” and curb the epidemic.
The emergency strategy worked. Over a two-week period in April, MSF helped carry out one of the largest cholera vaccination campaigns ever—vaccinating 423,000 people in Lusaka. More than 100 MSF and Ministry of Health staff worked with 1,700 volunteers to implement the vaccination campaign. The health ministry also continued to provide care for patients at cholera 24 treatment centers and worked to improve sanitation and hygiene. Thanks to these coordinated and timely efforts, the outbreak was successfully brought under control.