The Global Task Force on Cholera Control (GTFCC) outlined an ambitious goal, that is to cut cholera deaths by 90% by the 2030. It represents an partnership between 50 United Nations (UN) and international bodies, non-governmental organisations and academic institutions of countries plagued by cholera1.

Cholera afflicts 1.3 to four million people annually – killing about 100,000

Cholera is caused by the bacterium Vibrio cholerae. Victims suffer from severe watery diarrhoea anywhere between 12 hours to five days after ingesting contaminated products. The resulting dehydration can kill within hours if left untreated. The infectious disease is an easily treatable one. However, rapid access to oral rehydration salts, clean fluids, cholera vaccines and proper waste management are key to decreasing patient mortality1.

It is no surprise that cholera outbreaks are often linked to impoverished areas that lack clean water and sanitation facilities. War-torn Yemen is currently struggling with one of its worst cholera outbreaks on record – with more than 770,000 people infected and 2,000 dead in the past five months alone. Many of its victims were children. Haiti still struggles with cholera seven years after the devastating earthquake in 20102.

A multi-pronged approach essential in eradicating cholera

The GTFCC revamp is the latest by WHO in efforts to curb major diseases. Its first new plan – “Ending Cholera: A Global Roadmap to 2030” – aims to work on 47 countries afflicted by cholera. The plan outlines three key approaches that it plans to employ.

Firstly, the global roadmap focuses on containing cholera outbreaks with early detection and quick response. This involves engaging the community, implementing warning systems, bolstering laboratory facilities, ensuring ready health supplies and having medical personnel on standby in the event of an outbreak.

These efforts will be targeted on endemic “hotspots” where outbreaks are predictable – forming the second key approach of the plan. Cholera has displayed clear patterns of regions that it is most likely to hit first, such as rivers, coastal waters and estuaries. Thirdly, the GFTCC hopes to serve as an international platform where technical and financial resources can be pooled together in supporting the global fight against cholera.

With these strategies, the GTFCC is confident that as many as 20 countries can be declared cholera-free by 20303. “The disease takes its greatest toll on the poor and the vulnerable – this is quite unacceptable. This roadmap is the best way we have to bring this to an end," comments Dr Tedros Adhanom Ghebreyesus, Director-General of WHO1.

Multi-sectoral interventions in cholera hotspots as called for in the “Ending Cholera: A Global Roadmap to 2030” plan. Photo credit: WHO
Multi-sectoral interventions in cholera hotspots as called for in the “Ending Cholera: A Global Roadmap to 2030” plan. Photo credit: WHO

Ending cholera is a “moral obligation” – no one should die from cholera in the 21st century

Cholera eradication plans are not without their challenges. Over two billion people globally do not have access to water sanitation and hygiene (WASH), despite its recognition as a basic human right. The fear of economic backlash and international stigma often result in inadequate reporting4. Funding remains a constant issue, resulting in medical supply shortages and a lack of medically trained staff.

Furthermore, countries act only after a full-blown crisis has materialised. Interventions at this stage do not address the underlying issues. “To truly stop cholera outbreaks, countries must do two things: deploy vaccines where cholera is endemic and strengthen the infrastructure that provides clean water and good sanitation,” writes Anita Zaidi, director of Vaccine Development, Surveillance, and Enteric and Diarrheal Diseases at the Bill & Melinda Gates Foundation in Washington, US2.

Dr Ghebreyesus urges international unity in combating cholera. “This is a disease of inequity that affects the poorest and most vulnerable. It is unacceptable that nearly two decades into the 21st century, cholera continues to destroy livelihoods and cripple economies. We must act together. And we must act now.” he urges1.  MIMS

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