roamopedia
A footbridge over the spray and rapids near Victoria Falls on the Livingstone, Zambia side of the Zambezi River.
Photo: Inas66 · Wikimedia Commons · CC0

· · Last updated

Contents
  1. Malaria
  2. Yellow fever certificate
  3. Other recommended vaccinations
  4. Schistosomiasis and freshwater
  5. Water safety: Copperbelt contamination
  6. Healthcare quality and paying for it
  7. Practical tips
  8. What to check before you go

The main health risks in Zambia are malaria across the whole country, schistosomiasis from freshwater contact, and healthcare that thins out fast once you leave Lusaka and the main tourist towns. None of this should put you off a safari or a trip to Victoria Falls, but it does mean sorting antimalarials, checking your vaccines and buying evacuation-grade travel insurance before you fly.

Malaria

Malaria is present across the whole country, including Lusaka, the Victoria Falls area and all the main safari circuits, so there is no low-risk region to plan a trip around. UK health advisory body NaTHNaC recommends antimalarial tablets for every traveller, with atovaquone-proguanil, doxycycline or mefloquine as the options to discuss with a doctor or travel clinic. The US CDC takes the same view, noting documented chloroquine-resistant Plasmodium falciparum and recommending a prescription antimalarial for all travellers regardless of trip length. Combine whichever tablet you’re prescribed with bite avoidance after dusk, since no antimalarial is fully protective on its own.

Yellow fever certificate

Zambia does not require a yellow fever vaccination certificate simply for entering the country, but a valid certificate is required if you are arriving from a country with yellow fever transmission risk, for travellers aged one year and over. The certificate is valid for the vaccinated person’s lifetime once issued. NaTHNaC adds that the vaccine itself is not generally recommended for a Zambia trip on its own merits, except for travellers aged nine months and over with low exposure risk heading to Northwest or Western provinces for a prolonged stay, where it may be considered. Check your own routing, including layovers, against the certificate requirement rather than the vaccine recommendation; they’re two separate questions.

The CDC recommends hepatitis A and typhoid for most travellers to Zambia, hepatitis B for travellers under 60, and rabies if your trip includes activities that bring you close to animals, such as caving, cycling or handling wildlife. Cholera vaccination is worth discussing given the CDC’s description of widespread cholera transmission in the country. The CDC also flags leptospirosis, dengue, African sleeping sickness (trypanosomiasis) and tuberculosis as risks present in Zambia, mostly relevant to longer stays, rural travel or specific activities rather than a short safari itinerary. Book a travel health appointment several weeks ahead, since some vaccines need more than one dose spaced over time.

Schistosomiasis and freshwater

Schistosomiasis (bilharzia), a parasite picked up through skin contact with contaminated freshwater, is a recognised risk in Zambia’s lakes, rivers and dams. NaTHNaC advises against wading, swimming or bathing in untreated fresh water, which includes spots that look tempting on a Zambezi houseboat trip or a stop at a riverside lodge; chlorinated pools carry no risk. The same freshwater caution extends to drinking water: stick to boiled, filtered or bottled water rather than water straight from a river, lake or tap of uncertain treatment.

Water safety: Copperbelt contamination

UK government travel advice warns of heavy-metal contamination in rivers in Zambia’s Copperbelt province following a mine incident in February 2025, and advises against bathing in, or consuming water or fish from, the affected rivers. Boiling does not remove heavy metals, so treating the water yourself is not a workaround; avoid it entirely if your itinerary takes you through the Copperbelt and ask locally which waterways are affected.

Healthcare quality and paying for it

Healthcare facilities in Zambia are of a lower standard than in the UK, with rural facilities described as basic and emergency response services limited outside the main towns. HIV prevalence among adults is around 11%, one of the factors UK advice cites when recommending caution around any medical or dental procedure involving blood products or unsterilised equipment. Given the limits on local care, travel insurance that explicitly covers medical evacuation is essential for any itinerary outside Lusaka, since a serious injury or illness elsewhere in the country may need evacuation to reach adequate treatment.

Practical tips

  • See a travel clinic or doctor 4-6 weeks before you go to arrange antimalarials, any remaining vaccinations and a yellow fever certificate if your routing needs one.
  • Pack repellent and cover up after dusk even if you’re taking antimalarials.
  • Skip swimming, wading or bathing in lakes, rivers and dams; drink only boiled, filtered or bottled water.
  • If your itinerary includes the Copperbelt, check locally which rivers remain affected by the 2025 contamination and avoid them entirely, including for fish.
  • Buy travel health insurance that explicitly covers medical evacuation before you leave.

What to check before you go

  • Whether your routing counts as arriving from a yellow-fever-risk country, including layovers, with your airline or embassy.
  • Which antimalarial suits your health history and trip length, with a travel clinic.
  • Whether your Copperbelt route passes through an area still affected by the 2025 heavy-metal water contamination.
  • Your travel insurance policy’s evacuation cover, before you need it.