We watch anxiously as the white WFP humanitarian truck in front of us ploughs through a waterlogged dirt road. The truck is enroute to reach vulnerable and displaced communities in desperate need of relief supplies. The truck crosses a perilously looking makeshift wooden bridge and slippery terrain. Finally, we arrive at Katuma camp situated 31 km away from Mulanje Town which is close to the Mozambique border. Mulanje district lies 67 km west of Blantyre, Malawi’s commercial capital. In Mulanje district alone, 67,233 women and girls are seeking shelter in camps after their homes were wrecked.  At Katuma camp 456 women, men and children need relief items.. The camp comprises of a one room brick structure where 340 women and children are staying, while 116 men are cramped in a small, thatched structure. As the truck contents begin to be offloaded, the line of people to receive items slowly begins to grow. The camp protection committee works swiftly with the district and UN Women staff to organize the camp community. There is a general sense of relief in the area as pregnant women start receiving emergency supplies. Seven-months pregnant Rebeca Kabisala narrates her ordeal, “It rained non-stop for days, when one of the walls in my house collapsed, I ran out quickly-I lost everything. This blanket I have received will keep me warm in the overcrowded camp”. As the hours pass by, rows of lactating mothers, adolescent girls, women, persons with disabilities, the elderly as well as boys of all ages and men approach the truck to receive items. Edna Mishioni, 35,  smiles as she opens a bucket she has just received. “Managing menstrual hygiene has made me so anxious since we came here. Now, I don’t have to be ashamed and stressed because I have sanitary pads” she says. Venika Mangwaya is led to the truck by her young grandson. “Seeing all this maize flour is a miracle, the children in the camp can eat more than one meal a day”. A few kilometres away from Katuma camp, a church building has been turned into a camp. Forty-two-year-old Annie Makukenya excitedly switches on a solar lamp she has been given. “The building we are sleeping in is always dark, this lamp will make us feel safer and the children can read at night”. Maria John, a local volunteer who works in ten camps in the area says humanitarian response must include and deliberately target women. “When disasters like these floods strike, organizations must respond to the unique needs of women and girls, we applaud UN Women for doing this” she says. As the sun begins to set, the truck drives away having distributed to almost 500 households in four camps in traditional authority Mkanda in Mulanje. Early March 2023, Malawi was hit by Tropical Cyclone Freddy that induced floods and mud slides in 15 districts in Southern region. As of 27th March 2023, approximately 2,267,458 people (1,110,639 males, 1,156,819 females and 234,729 people living with disability) have been affected. This is 11% of Malawi population estimated at 20,428,275. The number of displaced people is at 659,278 with 747 camps commissioned to accommodate the displaced. It is estimated that 65% of the displaced people are women. The death toll is at 679. The number of injured persons is at 2178. The number of reported missing persons is at 537. The torrential rains, mud slides and floods caused a lot of damage to infrastructure including houses, roads, household property, schools, health facilities and displaced many households. UN Women has donated relief items, including hygiene kits, blankets, wrappers, solar lamps and food worth US$30,000 to those affected by Cyclone Freddy.

Malawi's worst cholera outbreak has left Penjani Chunda with little time to rest since its onset in March 2022. Every day, the district environmental health officer in Blantyre receives reports, calls and visitors to refine strategies to make the fast-spreading disease history. During the meeting, he was dispatching teams, medicine and essential supplies to cholera hotspots. However, his job  got harder when Cyclone Freddy struck southern Malawi, triggering severe landslides and flash floods that displaced thousands, with more than 100 people confirmed dead and about 30 missing in Blantyre.  Animated by early warnings from the weather department, ambulance teams swiftly evacuated all cholera patients from health centres to an isolation zone at Queen Elizabeth Centre Hospital (QECH) to reduce the potential deaths, injuries and damages. In the aftermath of the tragedy, the health workers focus switched from the raging outbreak that has claimed 1, 724 lives from about 56,876 confirmed cases in a year, to the influx of wounded patients and bodies from areas devastated by the cyclone. "It was hectic and we had no time to adjust. We had to deal with two emergencies that are not only related but also devastating on the community where we work," says Chunda. The country's deadliest natural disaster exerted immense pressure on the healthcare system already grappling with a high disease burden, including the polio resurgence, the Covid-19 pandemic and the raging cholera emergency that followed Tropical Storm Ana, which affected nearly a million people nationwide. "It wasn't easy to deal with the double blow, but teamwork always wins," says Chunda, who coordinates disease surveillance, prevention and control in all 37 health centres in Blantyre, which has been hit the hardest by both cholera and the world's longest-running cyclone, Freddy. He marshalled the emergency transfer of cholera patients to the facility that housed Covid-19 patients during the coronavirus disease's second wave in 2020. Maria Malele a community nurse prepares to assess malnutrition on one-year-old Obadia Andrea Chunda explains: "The cyclone affected the cholera response, including treatment units that were pulled down once the patients had been evacuated to QECH, where we already had a camp fit for the purpose. Despite the horrifying disaster, no camp fell on a patient," he explains. The cyclone has stirred a surge in cholera cases in Blantyre just when the national disease burden is falling. Daily updates by the Ministry of Health show Blantyre’s count has surged to 45  from 20 to 30 before the storm.  "The numbers are rising sharply due to a breakdown in access to safe water, sanitation and hygiene at a time we expected the double-digit counts to fall below 10," he says. Due to the disruptive disaster, Chunda preventive health teams suspended a nationwide campaign to vaccinate people against cholera and Covid-19 in communities where they live and work. "To us, the surge is a cause of worry. We expect a worse outbreak since the cyclone destroyed water and sanitation facilities in its way.  This is a double blow because it is happening amid a cholera outbreak sparked by last year's cyclones.  With the current cyclone, our neighbours in Mozambique, who were also hit hard, have also been affected by cholera," he explains. The affected population requires soap for hand-washing, buckets for water storage, chlorine for water treatment and public awareness, especially on preventive measures. "We need urgent support to protect the devastated communities and remind them of the importance of insisting on safe water, sanitation and hygiene," he says. The Ministry of Health has deployed community health workers to all emergency evacuation camps to conduct health talks and chlorination in a desperate effort to avert the potential cholera eruption among more than 350 000 people displaced by the cyclone. Camps in Blantyre have six confirmed cholera patients within two weeks. These include three recorded at Mpingwe camp, two at Manja and one at Mbayani. "The good news is that the spread has been kept under control, but this confirms our fears that poor sanitation and hygiene could turn the overcrowded camps into super spreaders of cholera," Chunda warns. Equally worried is community nurse Maria Malele, one of the health workers who worked day and night to save the lives of cholera patients amid the humanitarian crisis caused by Cyclone Freddy. Her work in the 43-bed cholera treatment site at QECH just got harder with the new arrivals from the city's hotspots, including devastated zones and congested camps. "Our workload in the cholera treatment centre increased dramatically with the cyclone. Few hands had to care for an increasing number of patients as many health workers turned to assisting casualties from disaster zones. "For the past two weeks, we have been knocking off late when there are many patients. Ours is a calling, so we cannot live with patients because it is time to clock out," she explains. Malele's daily workload can only get bigger unless the resurgent cholera wave is kept in check. "Since the devastating cyclone, cholera patients are increasing because thousands of survivors are living in crowded camps with limited access to safe water, hygiene and sanitation. With dry taps in many areas, most households depend on unprotected sources contaminated by waste from shattered latrines and settlements," she explains. Mariam Andrea was taken ill by cholera. After spending five days at the main cholera treatment camp amid the battering cyclone, she returned to the facility when her two sets of twins contracted the fast-spreading, sanitation-related bacterial disease.

The devastation caused by the cyclone in Madagascar, Malawi and Mozambique has increased the spread of cholera and malaria, as well as malnutrition.   Meanwhile, more than 300 health facilities have been destroyed or flooded in the three countries, limiting health care access.   The cyclone’s destruction increased public health risks including a surge in the spread of cholera, malaria, malnutrition, COVID-19, and other vaccine-treatable diseases.   WHO said that Malawi was still in the midst of its “worst-ever” cholera outbreak, although cases are declining. In Mozambique, cholera cases have more than doubled over the past week, to almost 2,400.   “With a double landfall in less than a month, the impact of Cyclone Freddy is immense and deepfelt”, said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa.   “While we work to understand the full extent of the devastation, our priority is to ensure that affected communities and families receive health assistance for immediate needs as well as to limit the risks of water-borne diseases and other infections spreading,”   Helping communities prepare for climatic hazards Overall, flooding, and torrential rains have affected more than 1.4 million people in the three countries. WHO and partners are providing support in the form of cholera treatment centers, medical supplies, and health worker training.   WHO has provided U$7.9 million and sent over 60 experts to the affected countries to assist with the emergency response.   Around 184 tons of important medical supplies have been shipped to support the cyclone and cholera emergency response. In Malawi, WHO has redistributed cholera response operation centres to hotspot districts, to help disease control efforts.   “With the rise in climate-related health emergencies in Africa, it’s clear that more needs to be done to bolster preparedness to climatic hazards so that communities can better cope with the impacts of the devastating natural disasters,” said Dr Moeti.   The cholera outbreaks are currently affecting 14 African countries and are being made worse by extreme climate events and conflicts that leave countries more vulnerable. Many people have been forced to flee their homes, to face uncertain living conditions.

Globally, we are at a critical moment in history, facing growing crises, the COVID-19 pandemic, climate disruption, environmental degradation, conflicts, and the consequent global economic crisis along with rising inequalities. But we also have an enormous opportunity to transform the global economy and usher in an era of greater wellbeing and prosperity. The world’s Least Developed Countries (LDCs), Malawi included, are in a race against time to deliver the Sustainable Development Goals by 2030. The remaining years need to usher in a new global partnership to ensure these 46 countries transform their economies and achieve accelerated and sustained social-economic development. The Fifth United Nations Conference on the Least Developed Countries (LDC5) is a once-in-a-decade opportunity to accelerate sustainable development in the places where international assistance is needed the most and to tap the full potential of the LDCs helping them make progress on the road to prosperity. The LDC 5 is scheduled to take place in Doha-Qatar from 5th-9th March 2023 under the leadership of the United Nations Office of the High Representative for the Least Developed Countries, Landlocked Developing Countries and Small Island Developing States (UN-OHRLLS). Hosted under the theme “From Potential to Prosperity,” the LDC5 conference will bring together world leaders, the private sector, the civil society, parliamentarians, and young people to advance new ideas and raise new pledges of support and spur delivery on agreed commitments through the Doha Programme of Action (DPoA). This will be one of the biggest gatherings of world leaders in 2023, aiming to present an ideal opportunity to accelerate sustainable development and tap into the full potential of the LDCs. The conference offers a platform to lift the world’s least developed nations, including Malawi, out of poverty by building momentum around the implementation of the Doha Programme of Action. Discussions will focus on key issues facing LDCs including climate change, financing for development,  sustainable energy, resilience building, gender, youth empowerment, innovation and digitalization, trade, south-south cooperation, and knowledge sharing. For Malawi, the DPoA systematically aligns with the Malawi 2063 and the desire to be an inclusively wealthy and self-reliant industrialized upper-middle-income country by the year 2063. It offers a pathway to strengthen national efforts to eradicate poverty and build capacity to leave no one behind; leverage the power of science, technology, and innovation to fight against vulnerabilities; support structural transformation as a driver of prosperity; enhance international trade and regional integration; address climate change, and environmental degradation among others. Malawi is scheduled to handover the chair of the LDCs after completion of its tenure. One of the major milestones for the country during its tenure was overseeing the successful review of the 2011 -2020 Istanbul Programme of Action and the development and adoption of the DPoA. Malawi’s participation at the LDC5 Conference and subsequent implementation of the DPoA is expected to help the country to accelerate delivery of the Malawi 2063 first 10-year implementation plan (MIP-1) by improving economic infrastructure to promote exports and take advantage of the African Continental Free Trade Area (AfCFTA), spur foreign direct investments, improve human capital productivity, promote vibrancy and dynamism of the private sector to graduate the country to middle-income status, and promote climate change management and ecosystem conservation. As highlighted by the United Nations Secretary-General António Guterres ‘’the Doha Programme of Action reminds us that global recovery depends on LDCs getting the support they need.” The UN in Malawi is therefore committed to support the Government of Malawi and all stakeholders to accelerate achievement of Malawi 2063, the SDGs and realise Malawi’s vision of an inclusively wealthy and self-reliant industrialized upper-middle-income country by the year 2063 through this Programme of Action.