Cholera resurges in Zambia: Challenges and future directions

Abstract

Cholera remains a major global health challenge, disproportionately affecting low-income countries with inadequate water, sanitation, and hygiene (WASH) infrastructure. Zambia, historically prone to outbreaks, experienced a severe resurgence in 2023-2024, with over 10,887 cases and 432 deaths. The contributing factors include poor WASH access, systemic health care weaknesses, stigma, and logistical barriers. Only 32% of households have basic water services, and health care worker shortages persist, especially in densely populated areas. Misinformation and cultural practices hinder public health efforts, whereas fiscal constraints limit prevention strategies. Strengthening epidemic preparedness through WASH investments, systems thinking, predictive modeling, artificial intelligence–driven surveillance, and multi-sectoral approach integrating community engagement and health system resilience is essential to mitigate the outbreak. This commentary explores Zambia's cholera control challenges and outlines strategic directions for a resilient, sustainable response to this enduring public health threat.