By: Avery Sigler
In January 2020, Haiti was declared two-years cholera free, after a decade-long struggle to eliminate the disease, which was not native to the island. While left unacknowledged until 2016, cholera was introduced by UN volunteers who came from Nepal to help Haiti after the devastating 2010 earthquake. Only ten months later, in November of 2020, there were 600 confirmed cholera cases, and another 6,500 suspected. Haiti was no longer cholera-free, and a new pandemic was about to begin.
As of April 11, there have been a total of 31,705 cholera cases worldwide, with a case fatality rate of 2.2 across the global south, including Africa and the Caribbean. The UK, where the largest outbreak of cholera occurred in the mid-19th century, has not had a case since 1893. These cases are primarily concentrated in former colonies, with twenty-five of the twenty-seven countries with recent reported cases fitting this descriptor. The World Health Organization classified the cholera pandemic as a grade three emergency in January 2023, its highest internal level for emergencies. And yet, it has barely made the news.
You would be hard-pressed to find someone who does not understand the implications of pandemic in 2024. However, in the case of a disease such as cholera, which has been eliminated for so many years, those in global north countries tend to overlook it likely due to the fact that it is a disease that is relatively isolated to low-income countries. Cholera is caused by the ingestion of food or water contaminated with the bacterium Vibrio cholerae. Severe forms of the disease without immediate treatment can kill in hours. There are many strains of the bacterium but only two - O1 and O139 - can cause outbreaks, though O1 has caused all recent outbreaks. The spread of the disease is easy to avoid if a country has proper infrastructure, such as sewer systems. In modern times, the disease only affects countries that can’t afford proper sanitation in the water-supply. There also is a vaccine, known as the Oral Cholera Vaccine (OCV), but countries that lack the infrastructure for its development don’t have the means to vaccinate against it causing higher infection rates. In 2023, fourteen countries requested a total of 78 million OCV from the World Health Organization, but only 38 million were available. As of March 8th, only previous requests for vaccinations can be filled. Though this deadline has recently passed, a spike of cholera cases in another country that does not have the technology to replicate these vaccines, would be left completely vulnerable.
The othering of countries, from developed to developing, is likely the link between the high CFR and the underreporting in the media. From the perspective of global north nations, cholera is not a threat due to development on the backs of the countries suffering today. Those in the countries currently facing a cholera pandemic have to live with that constant fear, the same way that countries like the United States did during COVID-19, but without the infrastructure and the governmental influence to help to improve public health. Cholera may seem to the people in Western countries a disease of medieval times, but it is a very real threat to millions of people worldwide.
