Regional framework for the implementation of the global strategy for cholera prevention and control, 2018–2030: Report of the Secretariat
Abstract1.Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. It has a short incubation period of two hours to five days. The infection is often mild or without symptoms but severe in 20% of cases. It affects both children and adults. In severe cases, cholera can rapidly lead to death by dehydration within hours,if left untreated.2.Cholera mostly affects poor communities with low socioeconomic status. The most vulnerable populations are those residing in overcrowded areas with limited safe water and sanitation services,including unplanned mass urbanization. The 2017 WHO-UNICEF joint annual report on water and sanitation (based on2015 data) indicates that globally,663 million people lack access to safe drinking-water and over 2 billion people drink water from sources that have faecal contamination. In addition, displacements due to conflicts, natural disasters and extreme climatic changes are creating favourable conditions for cholera outbreaks in many settings across the globe.3.Due to the above risk factors, cholera has remained a major public health problem. Globally, an estimated four million cholera cases and over 140000 deaths are reported annually. In 2017alone, over 150000 cholera cases,including 3000 deaths, representing a case fatality rate (CFR) of 2.3%,were reported from 17countries in the African Region. More than 90% of these cases were from six high-burden countries.This raises concern about the potential further increase of the cholera burden, including large-scale outbreaks in big cities.4.Cholera is a recurrent outbreak with clear seasonality in most endemic areas. The persistence of cholera in these places reflects weaknesses in water and sanitation infrastructure and services, high-risk hygiene and social practices, gaps in surveillance and health care systems. In addition,insufficient political and financial commitments are contributing to prolonged recurrent outbreaks.More than 80% of affected countries report insufficient financing to meet their Water, Sanitation and Hygiene (WASH)targets.5.Due to the high and increasing cholera burden and numerous challenges,the Global Task Force on Cholera Control (GTFCC) developed a global roadmap to end cholera by 2030. This Regional Implementation Framework with key milestones will guide the Member States to implement the global strategy to achieve the elimination of cholera by 2030.6.The Framework proposes concrete actions which include,among others, enhancing epidemiological and laboratory surveillance,mapping cholera hotspots,improving access to timely treatment,strengthening partnerships and community engagement,increasing investments in clean water and sanitation for the most vulnerable communities,and promoting research. These will require increased political and financial commitments,coupled with meticulous monitoring and evaluation of implementation.7.The Regional Committee is invited to examine and adopt the actions proposed in this Framework.
Regional Committee for Africa, 68. (2018). Regional framework for the implementation of the global strategy for cholera prevention and control, 2018–2030: Report of the Secretariat. World Health Organization. Regional Office for Africa. https://iris.who.int/handle/10665/275121