The world is facing an upsurge in cholera, reaching even countries that have not had the disease in decades. Years of progress against this age-old disease are gone. While the situation is unprecedented, the lesson to be drawn is not new: safe drinking water, sanitation and hygiene are the only long-term sustainable solutions to end this cholera emergency and prevent future ones.
The global cholera situation is worrying, but as we commemorate World Water Day and begin the historic United Nations Water Conference in New York, the Global Task Force on Cholera Control (GTFCC) English) calls on countries and the international community to address this concern. towards concrete action.
First, to prevent future outbreaks, countries need robust public health surveillance systems to quickly identify and confirm cholera cases, allowing for immediate action. Countries with ongoing widespread outbreaks need immediate support to track and address the current crisis. We cannot solve a problem that we cannot see.
Second, stop the cycle that takes us from emergency to emergency by investing in water, sanitation and hygiene (WASH). When there is a cholera outbreak, first responders rush to carry soap and chlorine tablets, truck in drinking water and build temporary latrines to prevent the outbreak from spreading. While these actions certainly save lives, long-term investments in WASH infrastructure can prevent outbreaks in the first place. Wherever cholera has been eliminated in the world, it has been thanks to improvements in basic water, sanitation and hygiene: access to these is an internationally recognized human right.
Moving from an emergency response to long-term improvements is more effective, because although cholera is a health problem, it is first and foremost a development problem.
Third, concentrate efforts on the sources of anger. The fight against cholera requires a specific approach focused on hotspots (health zones or districts) where cholera cases are concentrated. Focusing on cholera hotspots more than doubles the return on investments in drinking water, sanitation, and hygiene—from $4.30 to $10 for every $1 invested.
Four, support the development and implementation of national cholera plans, including the budget allocated for WASH. These national plans set out the multisectoral actions necessary for the sustained prevention and control of cholera, including the use of oral cholera vaccines, putting communities at the center.
Poverty, conflict and disaster continue to fuel cholera, now fueled by climate change. The future presents multiple challenges, but at least for cholera, we have the answer: access to drinking water, sanitation and hygiene in cholera hotspots. Urgent and targeted investments will get us there.
Note to editors
In recent months, the world has seen a resurgence of cholera. Last year, up to 30 countries experienced outbreaks, and we continue to see worrying geographic spread into 2023. Countries like Lebanon, South Africa, and Syria are seeing their first outbreaks in decades. It is not just the number and spread of the outbreaks that is worrying, but the severity with which they are hitting. The average case fatality rate of the current outbreaks is double the target threshold of less than 1%.
Many of these outbreaks have clear links to extreme weather events, sometimes bringing too much water and sometimes too little, constituting potent fuel for cholera as access to water supplies is cut off and people may be forced to moving from their homes to more temporary and sometimes crowded settlements. Looking ahead, we can expect more frequent floods, droughts, storms and displacement. In addition to climate change, modeling exercises show that population growth and urbanization alone could double cholera cases in the next 20 years if we don’t act now.
For more information on the comprehensive multisectoral approach to cholera control and elimination, see the GTFCC Steering Committee Statement on the current cholera situation.
Signed by the Steering Committee of the Global Task Force for Cholera Control (GTFCC)
His Excellency Mr. Hakainde Hichilema, President of the Republic of Zambia and World Champion of Cholera Control
Dr. Frew Benson, Chair, GTFCC Steering Committee
Dr. Christopher J. Elias, President, Global Development, Bill & Melinda Gates Foundation
Dr. Howard Zucker, Deputy Director of Global Health, Centers for Disease Control and Prevention (CDC)
Dr. Seth Berkley, CEO, Gavi, the Vaccine Alliance
Dr. Tahmeed Ahmed, Executive Director, icddr,b
Jagan Chapagain, Secretary General, International Federation of Red Cross and Red Crescent Societies (IFRC)
Dr. Christos Christou, International President, Doctors Without Borders
Catherine Russell, Executive Director, UNICEF
Dr. Tedros Adhanom Ghebreyesus, Director General, World Health Organization
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