This document outlines the plan for a continental cholera prevention and control with the implementation framework for the Cholera IMST, detailing its governance structure, strategic priorities, and operational modalities
The greatest risk to persons engaging in international medical emergency response is poor preparation.
The In Control handbook hopes to provide a remedy.
At the time of writing, we are living through the Coronavirus (COVID-19) pandemic, a health emergency that disregards physical borders, brin...gs into focus social inequalities and affects people on every continent. This shared challenge requires unprecedented measures and the collaboration of the brightest minds to support global health protection through this crisis and beyond. Healthcare infrastructures have to be strengthened, public health capacities and processes upgraded, medical countermeasures and vaccinations found and psychosocial side-effects treated.
Solidarity is the normative order of the day and the human species has to collaborate to face this invisible threat. Hiding and living in fear is not an option in this interconnected world. We have both a responsibility and an opportunity to make substantial contributions to a safer, healthier and more sustainable future for us all.
The existence of this handbook is an impressive example of solidarity. Over 50 authors from more than 15 institutes and organisations have come together voluntarily within a very short time to make their expertise available and enable cross-sectoral thinking. Knowledge is bundled, resources are combined, information gaps are filled. The In Control handbook is not a theoretical treatise of possible dangers, but a collection of subject-matter expertise, written by experts and practitioners who have shaped health topics over the past 20 years in the most diverse corners of the world.
The Centre for International Health Protection at the Robert Koch Institute (RKI) is collaborating with its partners and investing heavily in the build-up of operational know-how and capacity to support health crisis response abroad. This is done by preparing and enabling professionals to deploy safely across the world to assist those in need. In Control addresses the multi-faceted challenges of an international deployment. Readers will find not only technical medical information, but also insights into, for example, the fragility of our environment, the cultural differences that influence risk communication or the dilemmas arising from social distancing. Legal principles are highlighted, along with ethical guidance to ensure that our actions and decisions correspond to the highest moral standards.
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The document is a comprehensive practical guide for managing cholera epidemics. It includes detailed instructions on outbreak investigation, control measures, case management, and the organization of treatment facilities. It emphasizes strategies such as rehydration therapy, water sanitation, hygien...e promotion, and vaccination to prevent the spread of cholera. The guide serves as a resource for healthcare professionals, logisticians, and public health officials to respond effectively to cholera outbreaks.
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The National Integrated Comprehensive Cholera Prevention and Control Plan (2017-2022) outlines Uganda's strategy to reduce cholera cases and mortality by 50% by 2022. The plan focuses on improving access to clean water, sanitation, and hygiene (WASH), strengthening disease surveillance, enhancing ca...se management, and implementing oral cholera vaccination (OCV) in high-risk areas. It emphasizes multi-sectoral collaboration, involving government agencies, NGOs, and local communities to ensure a sustainable response. Key interventions include community engagement, improved health services, and better outbreak preparedness, aiming for long-term cholera elimination in Uganda.
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Water, sanitation and hygiene (WASH) are critical in the prevention and care for all of the 17 neglected tropical diseases (NTDs) scheduled for intensified control or elimination by 2020.
Provision of safe water, sanitation and hygiene is one of the five key interventions within the global NTD ...roadmap. Yet to date, the WASH component of the strategy has received little attention and the potential to link efforts on WASH and NTDs has been largely untapped.
Focused efforts on WASH are urgently needed if the global NTD roadmap targets are to be met. This is especially needed for NTDs where transmission is most closely linked to poor WASH conditions such as soil-transmitted helminthiasis, schistosomiasis, trachoma and lymphatic filariasis.
This strategy aims to mobilise WASH and NTD actors to work together towards the roadmap targets.
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The Zimbabwe Multi-Sectoral Cholera Elimination Plan (2018–2028) aims to eradicate cholera by improving water, sanitation, and healthcare infrastructure, strengthening disease surveillance, and expanding oral cholera vaccination (OCV). The strategy focuses on five pillars, including public health ...response, WASH, infrastructure, community empowerment, and financing. A multi-sectoral approach involving government, international organizations, and local communities targets cholera hotspots to prevent outbreaks and ensure long-term disease control.
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The report offers 20 top recommendations for getting ahead of future outbreaks in Yemen and similarly complex humanitarian settings.
In 2015, Yemen was declared a Level 3 emergency by the UN, kicking into gear the highest level of humanitarian support. A massive cholera outbreak followed, leading t...o 1 million suspected cases in 2 waves from September 2016-July 2018.
“We largely know ‘what to do’ to control cholera, but context-specific practices on ‘how to do it’ in order to surmount challenges to coordination, logistics, insecurity, access and politics remain needed,” the report states.
While the response improved between the 2 waves, there were gaps. For one, Yemen’s history of cholera should have triggered a heavy focus on pre-planning for an epidemic, such as stockpiling supplies and doubling down on community-based surveillance, the report fou
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Practical guide for doctors, nurses,laboratory technicians, medical auxiliaries,water and sanitation specialists and logisticians.
The document is a comprehensive guide for managing cholera epidemics, providing detailed protocols for prevention, outbreak investigation, treatment, and control mea...sures. It covers essential aspects like rehydration therapy, water sanitation, hygiene promotion, and setting up treatment centers. Designed for medical and non-medical staff, it aims to support effective epidemic response and reduce cholera-related morbidity and mortality.
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This report is primarily intended for the community of policymakers and researchers concerned about the rising risks of domestic, regional, and global infectious disease epidemics, and the collective failure to take the coordinated actions required to reduce such risks. These risks include the expec...ted health, economic, and societal costs that are borne by countries, regions, and even all nations in the case of pandemics (which are worldwide epidemics). These risks also include the consequences of increasing antimicrobial resistance (AMR) and its spread within regions and globally. A necessary first step is to monitor whether a broad range of stakeholders are acting to prevent outbreaks from becoming epidemics, whether their capacities to respond to epidemics are robust, and whether preparedness to respond to pandemics and limit the resulting economic and health damage is improving. Analyzing the adequacy of these efforts is vitally important for the decisions of policymakers to invest in the public health and disaster-risk management capacities. Early and effective control of disease outbreaks prevents substantial health and economic costs whether or not the disease can spread globally and become a pandemic.
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This review of the IFRC support to the Sierra Leone Red Cross Society response to the 2012 cholera outbreak provides ideas and concepts to promote a more coherent and evidence based rationale on how to make more effective use of IFRC global assets to stop, control, mitigate and respond to cholera ep...idemics. No fit and healthy person should die from cholera – that should be the indicator of success.
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In Control imparts knowledge, provokes reflection and triggers curiosity. The first half of the book provides an overview of the organisations, principles, frameworks and themes that every professional deploying to health emergencies should be aware of. The second half of the book provides practical... advice to help professionals survive and thrive during their mission – from staying healthy, protecting oneself from cyber-attacks and coping with stress to building trust among the host community or dealing with language barriers and the press.
This handbook is free of charge and can be made available in small quantities as long as supply lasts. To order, please send this form to: incontrol-handbook@rki.de
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The importance of robust mortality surveillance systems cannot be overstated in an era marked by increasing global health challenges where health threats loom large and population dynamics continue to evolve. Accurate and timely mortality data is essential for identifying trends and detecting emergi...ng health threats, evaluating the impact of interventions, and guiding evidence-based policy decisions.
This framework outlines a holistic approach to strengthening routine mortality surveillance systems, considering the unique contextual factors and challenges faced by African countries. It emphasizes the importance of establishing efficient data collection mechanisms, enhancing data quality and completeness, and promoting data sharing and collaboration among stakeholders.
Moreover, the framework recognizes the pivotal role of technology in the integration of data from fragmented mortality data sources. It highlights the potential of innovative data capture methods, advanced analytics, and real-time reporting systems to enhance mortality data’s accuracy, efficiency, and timeliness.
The continental framework for mortality surveillance aligns with Africa CDC’s mission and strategic goal by serving as a fundamental component in strengthening public health systems, enhancing disease surveillance capacities and capabilities, informing evidence-based policies and interventions, and promoting collaboration and coordination among African countries to address health challenges and improve health outcomes on the continent.
The successful implementation of this framework requires collective commitment and concerted efforts from governments, health institutions, and the international community. We hope this document will serve as a catalyst for transformative change, enabling countries to build resilient mortality surveillance systems that protect public health, save lives, and contribute to evidence-based decision-making.
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L'application de la technologie de santé numérique se développe rapidement en Afrique, dans
le but d'améliorer la prestation des services de santé et d'atteindre plus efficacement les
communautés éloignées et mal desservies. D'autre part, l'absence de lignes directrices et de
normes da...ns l'ensemble du continent rend difficile le partage des données de manière
significative sur l'ensemble du continent. C'est pourquoi les Centres africains de contrôle et
de prévention des maladies (Africa CDC) ont mis en place un groupe de travail composé de 24
membres afin de fournir une expertise et des conseils pour l'élaboration des lignes directrices
et des normes de l'UA en matière de HIE. Les membres du groupe de travail étaient des
experts en la matière travaillant en Afrique et au niveau international sur la collecte, l'analyse
et l'échange d'informations sur la santé. Certains de ces experts avaient participé à des
consultations antérieures sur la définition de la stratégie des systèmes d'information sur la
santé d'Afrique CDC. Un président, un coprésident et un secrétaire ont été élus pour impliquer
les membres de la tasé force dans différents groupes de travail techniques.
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In 2007, WHO warned that infectious diseases are emerging and re-emerging at a rate that has not been seen before. The potential for infectious diseases to spread rapidly results in high morbidity and mortality, causing a potential global public health treat of major concern.
Several factors are ...contributing to the (re)emergence of infectious diseases such as population growth, living in close contact with animals, frequent travelling, poverty, destructive ecological changes due to economic development and land use and climate change result in global warming.
Especially Africa is at a threat for (re)emerging infectious diseases due to the huge population growth (expected to reach 2.5 billion by 2050) with rapid urbanisation. Additionally, people across and beyond the continent are excessively mobile which is combined with a weak health system. Moreover, the risk of (re)emerging infectious disease is further heightened by three newly adopted continental initiatives: African Continental Free Trade Area, Free Movement of Persons and African Passport and Single African Air Transport Market.
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The document provides guidelines for the prevention and control of cholera outbreaks. It focuses on key strategies such as improving access to safe drinking water, ensuring proper sanitation, and promoting hygiene practices to prevent the spread of the disease. The guidelines also emphasize the impo...rtance of early detection, prompt treatment with oral rehydration solutions (ORS) or intravenous fluids, and the strategic use of antibiotics in severe cases. Additionally, it discusses the role of community education and collaboration with health authorities to effectively manage cholera outbreaks.
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This publication is a compendium of 49 country examples highlighting efforts in improving refugees’ and migrants’ health following the adoption of the WHO Global Action Plan on Promoting the health of refugees and migrants at the seventy-second World Health Assembly, in May 2019.
Each year since 2007, G-FINDER has provided policy-makers, donors, researchers and industry with a comprehensive analysis of global investment into research and development of new products to
prevent, diagnose, control or cure neglected diseases in low- and middle-income countries, making it the go...ld standard in tracking and reporting global funding for neglected disease R&D. This year’s report, the sixteenth overall, focuses on investments made in participants’ 2022 financial year (‘FY2022’) and, for the first time, adds comprehensive coverage of the product pipeline in each disease area.
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The document presents Cameroon's National Response Plan for the 2018 cholera outbreak, covering August to October 2018. It highlights the epidemiological situation, with outbreaks reported in the North and Central regions and a total of 109 suspected cases and 9 deaths by July 2018. The plan outline...s strategies for controlling the epidemic, including epidemiological surveillance, improved access to clean water, sanitation, mass vaccination, community awareness campaigns, and hospital and community-based treatment.
The response is coordinated by the Ministry of Public Health, WHO, and various partners, focusing on early detection, rapid response, and multi-sectoral collaboration. Challenges include poor sanitation, limited healthcare infrastructure, and cross-border disease transmission risks. The plan emphasizes resource mobilization, monitoring, and evaluation to contain the outbreak and prevent future cases.
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MEDBOX Issue Brief 26. Cholera is an acute diarrhoeal infection caused by eating or drinking food or water that is contaminated with the
bacterium Vibrio cholerae. Cholera remains a global threat to public health and is an indicator of inequity and lack of
social development. Researchers have esti...mated that every year, there are 1.3 to 4.0 million cases of cholera, and 21
000 to 143 000 deaths worldwide due to the infection.
However, cholera remains a neglected and underreported disease. Many cases are not recorded due to limitations in
surveillance systems and fears of potential impact on trade or tourism.
Today cholera affects 47 countries across the globe. Almost every developing country faces cholera outbreaks or
the threat of cholera. Major ongoing outbreaks are being reported from Afghanistan, Bangladesh, Democratic
Republic of Congo, Ethiopia and Nigeria. Major outbreaks are currently in Syria and Haiti.
Therefore, MEDBOX decided to produce issue briefs on cholera and available resources in Arabic, English and
French.
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