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Timely vaccination reinforces Malawi’s cholera outbreak control

Blantyre—Malawi experiences seasonal outbreaks of cholera associated with the rainy season between November and May every year. Most people in Malawi remember the 2022‒2023 outbreak as one of the most severe in the country’s history, with almost 60 000 cases and over 1770 deaths reported.  

The 2025‒2026 outbreak has been mild in comparison to the previous outbreak. As of 9 March 2026, 174 cases (111 local and 63 cross-border) from 14 districts had been confirmed. There have been four deaths so far.

To address ongoing reporting of cases, the Ministry of Health, with technical and operational support from World Health Organization (WHO), financing from Gavi, the Vaccine Alliance, and in coordination with other partners in Malawi, rapidly planned and implemented a mobile outreach oral cholera vaccination campaign in four priority districts. 

Timely vaccination reinforces Malawi’s cholera outbreak control
Chifundo Njala, 36, from Nambazo Village in Malawi’s Chiradzulu District heard about the oral cholera vaccination campaign from the village crier. “They said there will be vaccines to protect me against cholera and I decided to come here,” he says, indicating the vaccination site situated at a shady clearing on the outskirts of the village. “I am happy and I don’t have any concerns about being vaccinated,” he adds.
Timely vaccination reinforces Malawi’s cholera outbreak control
Any concerns Njala may have had were pre-empted during the planning phase of the campaign, in which health authorities briefed local leaders and used vans, town criers and community volunteers to spread the word.

Regina Kika, Nambazo’s village chief, was briefed ahead of time by her Traditional Authority and in turn informed the 100 or so households in her village, encouraging them to make use of these services to protect themselves against cholera. “It is important to be protected against cholera which has been a problem in my community,” she says.
Timely vaccination reinforces Malawi’s cholera outbreak control
Health authorities determined that ongoing reporting of cholera cases required swift intervention. With support from WHO they applied to the International Coordinating Group on Vaccine Provision for around 522 000 doses which arrived in the country on 11 February 2026.

The campaign ran for five days from 2 to 6 March 2026 and the 95% coverage target was surpassed.
Timely vaccination reinforces Malawi’s cholera outbreak control
Around 410 health surveillance assistants were deployed to the four districts, visiting homes, schools, churches, mosques and high traffic areas such as markets and bus stations to vaccinate people aged one year and older. Vaccination was also available at fixed sites, such as health facilities.
Timely vaccination reinforces Malawi’s cholera outbreak control
As well as encouraging vaccination, community leaders, alongside health authorities and partners, also ran community dialogues to inform their constituents about the dangers of cholera and the importance of good water, sanitation and hygiene practices.

“I encourage people to practice hygiene and to clean their toilets,” confirms Kika. “Also, our communal borehole has a bucket of chlorine for people to sterilize their household water.”
Timely vaccination reinforces Malawi’s cholera outbreak control
Aside from administering vaccines, health surveillance assistants also allayed fears and disseminated information on the safety and effectiveness of the oral cholera vaccine.

“I feel sad when people refuse to take the vaccine and adhere to advice we give them,” says Madalo Mbebuwa, a senior health surveillance assistant from Bangwe in Blantyre District. “We try as much as possible to talk with them little by little as behaviour change doesn’t happen in a day. It is a process.”

However, according to Mbebuwa, refusals were rare and most people accepted the vaccine.
Timely vaccination reinforces Malawi’s cholera outbreak control
WHO provided supportive supervision throughout the campaign, deploying 10 health emergency experts to the four districts. The Organization also supported risk communication and community engagement and trained 1350 health workers on safe and effective vaccine administration and disease surveillance.

“I congratulate the Government of Malawi on a rapid and effective oral cholera vaccination campaign,” says Dr Charles Njuguna, Acting WHO Representative in Malawi. “Along with access to clean water and sanitation facilities, as well as good hygiene practices, vaccination is an effective prevention method that WHO will continue to support.”
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Saida Swaleh

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WHO Regional Office for Africa
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