Zambia: Country Profile
Zambia is a land-linked country situated in the south-central part of Africa with a population of 19.6 million people. This unique location – surrounded by 8 economically interdependent countries – places the country at a high risk of being a hotspot for emerging and re-emerging infectious disease threats in the region. Addressing these threats requires a collaborative, multi-disciplinary and multisectoral approach. Zambia responds to public health events and emergencies in line with the International Health regulations (IHR) 2005. The Zambia National Public Health Institute (ZNPHI) is mandated to coordinate One Health in the country. In February 2023, ZNPHI in collaboration with other Ministries, Department and Agencies launched the National One Health Strategic Plan 2022-2026 to build a strategic, functional and sustainable platform that advances One Health. The strategic plan is divided into five thematic areas:
- Governance and Coordination
- Preparedness and Response
- Advocacy, Communication and Training
Priority Zoonotic Diseases
The Zambian government led a zoonotic disease prioritization workshop in mid-2023 and is in the process of finalizing and validating a list of 10 diseases. Before the prioritization workshop, anthrax and rabies were highlighted as diseases of concern in the country:
Anthrax is a bacterial infection that typically affects animals and can be transmitted from animals and animal products to humans, with limited human-to-human transmission. In endemic settings, anthrax affects primarily cattle, goats, and sheep, and the bacterial spores can remain in soil for years. The bacteria that causes anthrax can spread to humans through open wounds on the skin, ingestion, or inhalation of the spores. Anthrax outbreaks have occurred occasionally in Zambia, typically related to interactions with hippos or consumption of hippopotamus meat.
Rabies remains a widespread disease across the globe, responsible for tens of thousands of deaths worldwide each year. It is a viral infection transmitted by contact with saliva of infected mammals, mainly through bites and scratches and in most places, commonly through dogs. Children are particularly vulnerable to rabies. According to the Zambia National Public Health Institute, there are approximately 15,000 reported dog bites and 50 deaths from rabies annually (2018 data).
One Health Landscape
In Zambia, multi-sectoral technical working groups (TWG) form part of the One Health landscape. There are five TWG in line with the five thematic areas: Governance and coordination, Research, Surveillance, Preparedness and Response and Advocacy, Communication and Training. Permanent Secretaries from the key line ministries provide oversight to the TWGs. These are the key line ministries, organizations and departments that play a role:
- Ministry of Health
- Ministry of Green Economy and Environment
- Ministry of Fisheries and Livestock
- Ministry of Information and Media
- Ministry of Agriculture
- Ministry of Local Government and Rural Development
- Ministry of Tourism and Arts
- Ministry of Water Development and Sanitation
- Disaster Management and Mitigation Unit (DMMU)
- Ministry of Home Affairs and Internal Security (Police)
- Media houses (commercial and community)
- Various cooperating partners
Summary of existing Breakthrough ACTION research
The Breakthrough ACTION Zambia team conducted a desk review in early 2023 to identify existing reports and journal articles related to rabies or anthrax in Zambia. The results reflected known risk behaviors and the beliefs, attitudes, sociocultural factors, and structural factors that drive those behaviors. The findings also included previous campaigns to prevent anthrax or rabies including vaccination campaigns as well as mass media campaigns or community engagement. One Health and RCCE strategies were also reviewed. Based on the existing literature, barriers to desired behaviors exist at the individual, cultural, environmental, and structural levels. Economic factors play a major role in people’s willingness to vaccinate their animals or perform other desired behaviors. Cultural practices create risk when animals are transferred between families or carcasses are disposed of in an unsafe manner. Trust between communities, health workers, veterinary workers, and other health authorities is a potential leverage point for future interventions.
The Breakthrough ACTION team routinely conducts social listening exercises, beginning in January 2023. The team extracts social media and other web-based posts and analyzes them for sentiment, content, and other metrics. The purpose of the social listening is to identify newly emerging misinformation related to anthrax or rabies topics (including animal-human interactions) as well as to summarize online conversations generally related to the diseases of interest.