What happened, where and when?
In October 2024, the Ghana Health Service has announced a cholera outbreak affecting five regions in the country, notably: Greater Accra, Central, Western, Eastern and Asanti. As part of the interventions strategies to reverse the spread of the disease, Ghana Health Service in collaboration with UNICEF and partners in November 2024 introduced cholera vaccine- Oral cholera vaccine (OCV). The vaccine was rolled out in 3 subdistricts of the Central region, which is the epicenter of the epidemic, and 662,906 out of 792,482 eligible population were successfully vaccinated. Phase 2 subnational OCV campaign successfully completed in 18 subdistricts within 4 hotspot districts of Western Region (Sekondi-Takoradi, Effia Kwesimintsim, Shama and Ahanta West) between 15 to 18 December 2024. A total of 596,205 persons (92.9% of target population) were vaccinated. That said, the unvaccinated gap continues to pose a threat to since the vaccinate region is still reporting pocket of cases, and other affected regions as well. The Ghana RC has been quite active during the initial phases and needs more resources to continue playing its auxiliary role to the government in this response.
On December 19, 2024, the outbreak had claimed 27 lives and spread across 36 districts in the Greater Accra, Central, Western, and Eastern regions, with a total of 3,292 reported cases. As of December 23, a cumulative total suspected cases were 4,155 cases and 35 deaths with majority of the dead recorded withing 24 hours. While the number of cases in the Western Region is declining mainly due to the vaccination campaign, there is an increase in geographical spread and a rise in cases in the other regions. Between 24 and 31 december 2024, 29 new cases and 1 new death were recorded, with a cumulative number of 4850 suspected cases from the begining of the epidemic and 1 new affected district. These figures indicate that the epidemic continues to spread and there is a need to continue the initial efforts to ensure an efficient response.
Another fear is that with the recent torrential rains that affected Accra, drainage issues have been exacerbated, raising concerns that if these conditions persist, the situation could worsen significantly.
Historically, during epidemics and crises such as COVID-19, the Red Cross has consistently supported health services by providing social mobilization services. Whether the intervention involves vaccination, awareness campaigns, disease surveillance, or facility-based case management, the Red Cross is always present, advocating for, assisting, and representing the interests of the beneficiaries and local citizens. The health services highly value the auxiliary role of the Red Cross because, when their teams return to base, Red Cross volunteers remain as their "eyes and ears" on the ground, ensuring continuity of efforts and providing vital support remotely. Due to limited resources, Ghana RC was not able to continue playing its role of major actor in social mobilization and community awareness campaigns properly. It is expected that for the next steps the Red Cross can play a pivot role in contributing to the effectiveness of the national response to the cholera outbreak, leveraging its expertise and network.
Scope and Scale
The cholera outbreak began on October 4, 2024, when the first case was recorded after an individual exhibiting cholera-like symptoms sought medical care following attendance at a funeral in the Ada East District. The epidemic spread to 36 districts across five regions: Greater Accra, Central, Western, Eastern and Asanti. The limited information poses a challenge to evaluate the scope of the outbreak to the National Society. However, the last data from 31 December report 398 confirmed cases and 4850 suspected cases.
The health authorities indicated that the spread of the current Cholera outbreak in the country is closely linked to inadequate access to clean water and sanitation, making peri-urban slums and displacement camps high-risk areas. The pattern of the outbreak is mostly along the costal districts of Ghana. The general population is at risk with the most affected age groups being 21-30 years, followed by 31-40 years, which represent the active workforce. The Ghana Health Service indicated that unsafe water sources and food venders were the major sources and transmitters of the outbreak.
According to the Ghana Health Service, the epidemiological pattern of the cholera outbreak revealed a significant surge in cases just a few days before the general elections in Ghana. This surge peaked approximately five days after the elections, likely driven by the increased gatherings, mobility, and lapses in hygiene protocols associated with the electoral period. Following this peak, the number of reported cases begun to decline, offering a momentary respite. The NS however remains cautious, hereby raising concerns about the potential for another surge in cases due to the Christmas and New Year festivities. These celebrations are traditionally marked by widespread gatherings, increased patronage of bars and restaurants, and heightened domestic travel, all of which create conditions conducive to the transmission of cholera. Large crowds, limited adherence to hygiene practices, and the potential for food and water contamination during these festivities pose a significant public health risk. Additionally, the swearing-in ceremony of the newly elected government, typically accompanied by widespread jubilation and public celebrations, presents another potential trigger for a resurgence of cases. Events of this nature often involve gatherings in both formal and informal settings, where food and water safety standards may be compromised, further amplifying the risk of cholera transmission. In light of these risks, the NS emphasizes the importance of a DREF that will support proactive measures to prevent and manage the likely spike in cases.