Humanitarian Capabilities in Cholera Response
Slipping Away? A Review of Humanitarian Capabilities in Humanitarian Response
Date of publication: February 2023
Over the past two years, numbers of cholera outbreaks and deaths have increased significantly. The greater number of countries experiencing cases, combined with an unusual geographical distribution of outbreaks and unacceptably high case fatality rates, has raised concerns about the capacity for cholera response and control.
The report shows that the number of cholera cases is not unprecedented, when compared with figures over the past decade. However, for a manageable disease, the apparent rise in case fatality rates signals serious gaps in humanitarian response.
The report looks at the complex causes behind the increase in cholera deaths, and areas where the humanitarian sector can better coordinate and invest to prevent and respond to outbreaks.
Recommendations / learning
Humanitarian agencies have greater access to funding for response than for preparedness, meaning that funding for cholera control has been reactive, rather than being invested in safer WASH infrastructure or preparedness - cholera elimination will require longer-term investments in WASH and health programmes; in the meantime, there is a pressing need for increased access to rapid funding and joined-up coordination and action.
There is evidence of a decline in the provision of basic interventions, such as oral rehydration therapy (ORT), and a growing preference for over-medicalised interventions that are not necessary in most cases - humanitarian responders need to ensure there is sufficient capacity to provide ORT at a community level, which requires an emphasis on skills and training and public health messaging.
The cholera response suffers from a lack of leadership and weak coordination - as the key global cluster leads, WHO and UNICEF should take steps to clarify and strengthen their joint coordination role in cholera response.