A cholera outbreak has once again hit Zimbabwe. In an update to cabinet on June 13, 2023, the Acting Minister of Health and Child Care, Professor Amon Murwira, revealed that as of June 13, June 13, 2023, Zimbabwe had recorded 2,460 cases of cholera, 2,243 recoveries, 16 confirmed deaths, and 47 suspected deaths. This translates to a case fatality rate of 2.4%. Since the first incident in February, cholera cases have spread across the country in areas including Mutare, Bulawayo, Beitbridge, and Chimanimani, among others. However, Harare has been the most affected, with more than 700 cases reported from areas including Glenview, Mbare, Budiriro, and Dzivaresekwa.
This is not the first time that Zimbabwe has faced a cholera outbreak. The country experienced its worst cholera outbreak in 2008, killing over 4,000 people and infecting over 100,000. The outbreak occurred at the height of Zimbabwe’s economic and political woes and was imprinted in people’s memories through empty shop shelves, world-record hyperinflation, unceasing power cuts, the sewage flowing in the streets, and taps running dry. It is not a coincidence that another cholera outbreak has occurred at another moment in Zimbabwe’s timeline when the economy is in the doldrums and service delivery is suffering in most parts of the country. Across urban and rural areas, the reality is that local government and municipal authorities have failed to adequately provide services due to poor public resource management and the dire economic situation. Among the services that have been negatively affected are access to water, sewer management, and refuse collection, birthing the perfect conditions for diseases such as cholera to spread.

Following the cholera outbreak, the cabinet approved a budget of US$24 million for the cholera response in March. There is some evidence that the government is seized with addressing the cholera outbreak, as the weekly post-Cabinet briefings reference the issue. The government reportedly operationalized its Cholera Epidemic and Response Plan in the wake of the outbreak, initiating mitigation activities including awareness raising, screening at the country’s ports of entry, and instructing local authorities to undertake activities to address the spread of the scourge.

While the government’s response is commendable and may be to thank for the low case fatality rate and spread of the disease, the issue that urgently needs to be addressed regarding cholera is the breakdown of service delivery. The incidence of cholera correlates to poor service delivery, including increasing waste management and disposal, decaying sewage infrastructure, and intermittent availability of potable water. The Accountability Lab has conducted surveys on water and sanitation, refuse collection, and sewer management conditions in Harare, Bulawayo, Chitungwiza, and Goromonzi since 2020. A study in Glenview, Harare, with 176 respondents, found that all respondents had a burst sewer near their home, with 48% saying sewer bursts often occurred, 38% saying very often, and 14 % saying they did not happen often. In the same area, another survey about access to water found that water was only intermittently available. Most residents reported spending at least half the week without water, and most relied on wells as an alternative. A survey on sewer conditions in Mbare with 147 respondents found that 88% of respondents had a sewer burst close to their home, while 12% did not. Surveys have evidenced service delivery shortfalls in water and sanitation, sewer management, and refuse collection across Harare, Bulawayo, Goromonzi, and Chitungwiza, where the Accountability Lab and its partners work. Community-based organizations and residents’ associations across Zimbabwe have made similar conclusions on the service delivery situation.

But it is not only non-state actors who have flagged the poor service delivery conditions in the country. The government has detailed and up-to-date records of the country’s service delivery collapse from its departments, agencies, and oversight bodies. For instance, the local authority reports of the auditor general, presented to parliament, have for successive years painted a dire picture of infrastructure decay and poor service delivery in water and sanitation, sewer management, and refuse collection. In the 2021 report, for example, the then Auditor General Mildred Chiri reported that the number of registered service delivery issues had been rising over the years, with a 13% increase witnessed from 2020 to 2021. In that report, the Auditor-General flagged issues, including sewage flowing into Rufaro Dam in Marondera, lack of water and sewerage services in the Victoria residential area in Kadoma, and limited water pumping capacity in Masvingo, among other issues. Across the country, local authorities are experiencing frequent water leaks due to aging infrastructure. All this translates to citizens going without access to water for long periods and losing valuable water. Newer settlements like Epworth near Harare and Cowdray Park in Bulawayo do not receive running water and sewer services, posing a risk of diseases. The recent spread of cholera in Beitbridge’s Kwalu 2 residential area, where people settled on unserviced stands, is similarly attributed to the lack of running water and sewer services.
Poor service delivery is the elephant in the room regarding cholera in the country. While the current cholera outbreak has had a low case fatality rate and claimed fewer lives than the 2008 outbreak, it is still tragic that so many lives are lost to a disease that is quickly managed and treated. It is incumbent upon the government, across its tiers, to be proactive and take bold steps to improve service delivery, particularly in water and sanitation, sewage management, and refuse collection, to ensure that Zimbabwe does not experience another cholera outbreak. The government must distribute its resources effectively by planning, managing, and overseeing service delivery projects. Effective responsiveness to disease outbreaks alone is not enough.

Zibusiso John Dube is Accountability Lab Zimbabwe’s Programs and Campaigns Officer and Accountability Incubator Program Lead.