Pakistan among affected countries in 7th cholera pandemic

ISLAMABAD: Pakistan has once again found itself struggling with cholera amid a historic global surge in outbreaks, marking a disturbing resurgence of the 7th cholera pandemic as between 2022 and 2023, the world has seen an unprecedented increase in cholera outbreaks, including in countries that had either not reported cases in years or had invested heavily in multisectoral control strategies—such as Pakistan, Lebanon, Syria, and Haiti.

According to a recent World Health Organisation (WHO) call for urgent action, at least 30 countries reported active cholera outbreaks by April 2023, while another 20 countries sharing land borders with affected regions are at significant risk of transmission. Collectively, more than 1 billion people are now considered directly at risk of cholera globally.

In Pakistan, cholera re-emerged prominently in 2022, with outbreaks recorded in Balochistan, Sindh, and southern Punjab following climate-induced disasters such as flooding and the disruption of safe drinking water supplies. The increased frequency and intensity of extreme weather events—floods, droughts, and displacement—have directly contributed to the resurgence of waterborne diseases like cholera. The WHO report describes the current wave of cholera as “larger, deadlier, and more widespread than previous outbreaks”. It warns that the disease has returned with high mortality rates and is spreading even in areas considered cholera-free for years, representing a direct threat to global health security.

Cholera, a severe diarrheal disease caused by ingesting food or water contaminated with Vibrio cholerae, can kill within hours if left untreated. It is most prevalent in communities affected by poverty, conflict, poor sanitation, limited access to safe water, and fragile health systems—conditions that persist in parts of Pakistan despite years of health sector reform.

In 2022, Pakistan’s Ministry of National Health Services and provincial health departments reported thousands of suspected cholera cases in flood-affected districts. The National Institute of Health (NIH) in Islamabad had to issue health alerts and dispatch emergency response teams to prevent further spread in urban slums and displaced populations living in camps without proper sanitation.

Health experts say that timely diagnosis and treatment—primarily through Oral Rehydration Salts (ORS) and Oral Cholera Vaccines (OCVs)—can prevent most deaths. However, a lack of investment in water, sanitation, and hygiene (WASH) infrastructure, coupled with the pressures of Covid-19 and now inflation, has left many communities in Pakistan exposed to recurring disease cycles.