Africa in the Time of Cholera: A History of Pandemics

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Africa in the Time of Cholera: A History of Pandemics From 1817 to the Present

by Myron Echenberg, Reviewed by By Nicolas Van De Walle

September/October 2011.

These days, cholera is largely an African disease, with over 95 percent of all

cases worldwide over the past two decades occurring in Africa. In his

informative history of the seven cholera pandemics that have hit the continent

since 1817, Echenberg shows that this was not always so.

Epidemiologists agree that cholera originated in South Asia. Its arrival in

Africa at the beginning of the nineteenth century was testimony to the region's

growing insertion into global economic and social systems, as successive

pandemics followed trade routes, colonial armies, and African Muslims making

pilgrimage to Mecca. Back then, cholera was one of the most devastating diseases

known, killing millions. But over time, the virulence of dominant strains of the

disease have abated, and mortality rates have dropped sharply, particularly

since a highly effective oral rehydration therapy was mastered. Echenberg argues

that the 5,000–7,000 cholera deaths every year in Africa represent a failure to

provide public sanitation systems and access to clean water, often in failing

states that are riven by civil war. Indeed, in 2006, four countries accounted

for three-quarters of all cases on the continent: Angola, the Democratic

Republic of the Congo, Ethiopia, and Sudan...

http://www.foreignaffairs.com/articles/68194/myron-echenberg/africa-in-the-time-\

of-cholera-a-history-of-pandemics-from-1817-t