Diarrhoea kills more children under five worldwide than HIV, malaria and measles combined. In Zambia, it causes 40 young children's deaths every day and accounts for 840,000 clinic visits and 63,000 hospital referrals a year. Parents lack knowledge of how to prevent and treat diarrhoea at home and a severe shortage of trained health workers compounds the problem; Zambia has only seven nurses for every 10,000 people, one-ninth the UK rate.

Diarrhoea is one of the leading causes of death in children. That's why, since 2013, we've been working with the Centre for Infectious Disease Research in Zambia (CIDRZ) to prevent and treat diarrhoea. Piloting in Zambia's Lusaka Province, our three-year programme aims to halve diarrhoeal deaths and reduce overall child mortality by 15%. 

Introducing a new vaccine - saving thousands of lives

One of the most important ways in which we're working to prevent diarrhoea is introducing rotavirus vaccine: a new two-dose oral vaccine that prevents one of the most virulent strains of diarrhoea. When we launched in January 2012, Zambia became only the second country in sub-Saharan Africa to trial the vaccine. The pilot was so successful that the government has now launched a national campaign to make sure every child in the country is protected against rotavirus.

Building systems to introduce the vaccine seamlessly

Introducing a new vaccine into a national immunisation programme is no small feat: cold storage facilities need to be expanded, transport systems need to be strengthened, health workers need to be trained, and communities need to be encouraged to bring their babies to the clinic at the correct times. It's a long, inter-connected chain of activities that can be easily derailed. Sudan, the first country in the region to introduce the rotavirus vaccine, took more than four years from initial discussions to national roll out.

Along with CIDRZ, we worked hand-in-hand with the Ministry of Health for a year before our programme launched. This helped us make sure the right links and chains were forged or strengthened. That work paid off, not only in the successful pilot of the programme which to date has seen over 204,000 babies fully immunised, but also in laying the groundwork for what is now a national immunisation campaign.

Working with the London School of Hygiene and Tropical Medicine we have been using an innovative behaviour change campaign pulling together roadshows theatre, puppetry, radio, and community sensitisation designed to target parents and carers, called Komboni Housewives. So far we have reached 245,000 people across Lusaka Province and have supported local pharmaceutical companies to regulatory approval to produce ORS and zinc for the local market - with the hope that the supplements will become more affordable and widespread over time.

A landmark day for Zambia

The national roll out is a milestone in our programme, but most importantly it is a milestone for Zambia - every child in the country will soon have access to the life-saving rotavirus vaccine. We're continuing to support the government to address the burden of diarrhoeal disease by:

  • Working to improve rotavirus immunisation coverage in Lusaka Province
  • Training health workers to administer vaccines and to treat diarrhoea effectively with oral rehydration therapy and zinc
  • Supporting and educating communities in diarrhoea treatment, vaccination and prevention

Our programme in Zambia is supported by Comic Relief, GlaxoSmithKline and The Global Alliance for Vaccinations and Immunisation.

My story: Annette Mwiinga

Annette Mwiinga has seen for herself the difference that the rotavirus vaccine can make.

Annette is a 27-year-old mother of two children: Mwila, who is three, and Alex, who is nine months old. Annette’s family lives in one of Lusaka’s tiny unplanned shanties, with little or no water supply and sanitation.

She says: “My son Alex received the first dose of the rotavirus vaccine at six weeks and received another dose a month later.  He is growing well and he has not had problems with diarrhoea. Even when he did get it, it was not severe.

“I saw a big difference in him compared with my first child. With Mwila, the diarrhoea was often so bad, and we ended up being admitted to hospital. I just didn’t know how bad diarrhoea could be and we stayed there for two months, as Mwila ended up having severe malnutrition as well. 

“But with Alex, I really can see that the rotavirus vaccine is helping our children against diarrhoea. Us mothers, we love this vaccine so much.”