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The Zimbabwe Multi-Sectoral Cholera Elimination Plan (2018–2028) aims to eradicate cholera by improving water, sanitation, and healthcare infrast
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ructure, 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 response to a cholera outbreak must focus on limiting mortality and reducing the spread of the disease. It should be comprehensive and multisectoral, including epidemiology, case management,
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water, sanitation and hygiene, logistics, community engagement and risk communication. All efforts must be well coordinated to ensure a rapid and effective response across sectors.
This document provides a framework for detecting and monitoring cholera outbreaks and organizing the response. It also includes a short section linking outbreak response to both preparedness and long-term prevention activities.
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Humanitarian crises exacerbate nutritional risks and often lead to an increase in acute malnutrition. Emergencies include both manmade (conflict) and natural disasters (floods, drought, cyclones, ty
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phoons, earthquakes, volcanic eruptions, etc.). Complex emergencies are combinations of both manmade and natural disasters, often of a protracted nature. Millions of people are affected by humanitarian crises every year. The increasing frequency and scale of emergencies requires nutrition to be addressed in all phases of a response.
Crisis situations, whether acute or protracted, impact on a range of factors that can increase the risk of undernutrition, morbidity, and mortality. They may involve: the large-scale destruction of property and infrastructure; the erosion of livelihood strategies and purchasing power; a breakdown of and reduced access to essential services, including health services, water supply, and sanitation; and the displacement of large numbers of people. Emergencies can also disrupt social systems and the quality of care/feeding practices. Household access to food may be negatively affected and people may find themselves in overcrowded settlements with their families divided. As a result, at the individual level, there is often an increased risk of deteriorating health and nutritional status, resulting in a greater likelihood of death.
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The document "Proteksyon Maladi" focuses on preventing waterborne and hygiene-related diseases through practical measures. It emphasizes the importance of personal hygiene, including washing hands with soap
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and clean water before eating, after using the toilet, and during food preparation. Maintaining personal cleanliness is highlighted as a key step in preventing the spread of diseases.
Water safety is another critical focus, with recommendations to use treated or boiled water for drinking and cooking and to store water in clean, covered containers to prevent contamination. The document also addresses sanitation, encouraging the construction and maintenance of latrines to eliminate open defecation and promoting proper waste disposal to protect the environment and water sources.
Overall, the document serves as an educational resource, providing simple and effective strategies for communities to reduce the risk of diseases and improve public health through better hygiene, sanitation, and water safety practices.
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The document provides essential guidelines for preventing and managing acute diarrhoeal diseases, particularly in complex emergency situations such as conflicts, natural disasters, or health crises. It highlights the importance of access to safe dri
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nking water, sanitation, personal hygiene, and the prompt treatment of patients using oral rehydration solutions (ORS). The text also emphasizes the need for coordination between local and international actors to ensure an effective and sustainable response.
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Integrating neglected tropical diseases into global health and development: fourth WHO report on neglected tropical diseases evaluates the changing global public health landscape; assesses progress towards the 2020 targets;
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and considers the possible core elements of a strategic vision to integrating neglected tropical diseases into the 2030 Agenda of the Sustainable Development Goals.
Advances have been made through expanded interventions delivered through five public health approaches: innovative and intensified disease management; preventive chemotherapy; vector ecology and management; veterinary public health services; and the provision of safe water, sanitation and hygiene. In 2015 alone nearly one billion people were treated for at least one disease and significant gains were achieved in relieving the symptoms and consequences of diseases for which effective tools are scarce; important reductions were achieved in the number of new cases of sleeping sickness, of visceral leishmaniasis in South-East Asia and also of Buruli ulcer.
The report also considers vector control strategies and discusses the importance of the draft WHO Global Vector Control Response 2017–2030. It argues that veterinary public health requires a multifaceted approach across the human–animal interface as well as a multisectoral programme of work to protect and improve the physical, mental and social well-being of humans, including veterinary, water, sanitation and hygiene.
Integration of activities and interventions into broader health systems is crucial, and despite challenges, has the potential to accelerate progress towards universal health coverage while advancing the 2030 Agenda.
In short, this report drives the message home that “no one must be left behind”.
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The WHO Cholera Vaccine Position Paper (August 2017) highlights the importance of oral cholera vaccines (OCVs) as a key tool in outbreak response and prevention, alongside water,
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sanitation, and hygiene (WASH) measures. It recommends OCVs for high-risk populations, endemic areas, and humanitarian crises, emphasizing their effectiveness in reducing cases and mortality. The paper discusses two types of OCVs (Dukoral®, Shanchol™, Euvichol®) and supports the WHO-managed vaccine stockpile for rapid deployment in cholera-prone regions.
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Punjab Province Report: Nutrition Political Economy, Pakistan
Zaidi, Shehla; Bhutta, Zulfiqar et al.
Institute of Development Studies, Aga Khan University
(2015)
C1
In this report a nutrition governance framework was applied to research and analyse the provincial experience with nutrition policy in Pakistan, looking both at chronic and acute malnutrition. Twent
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y-one in-depth interviews with key stakeholders were also conducted along with a review of published and grey literature. Findings were validated and supplemented by consultative provincial roundtable meetings. Punjab’s nutritional puzzle is that it has high levels of chronic malnutrition and micro-nutrient deficiencies despite a surplus production of food and a low poverty level. Under-nutrition is mainly linked to insufficient attention to preventive health strategies and to a lack of connection between relevant sectors such as Education, Health, Poverty, Safe Water and Sanitation, and Food. Strategic opportunities are recommended which include cross-party political support and ownership for nutrition, with steering by executive leadership; multi-sectoral action and functional integration of various departments and programmes with the creation of a central convening structure for effective cross-sectoral coordination; broadening of nutritional activities beyond salt iodization and vitamin A coverage; central co-ordination of monitoring and evaluation and effective partnerships between the state and non-state sector around data production, awareness, advocacy, and monitoring.
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The Ethiopia Multi-Sectorial Cholera Elimination Plan (2022-2028) outlines a national strategy to eliminate cholera in Ethiopia by 2028. The plan follows the Global Roadmap to End Cholera by 2030 and is based on six key pillars: Leadership & Coordin
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ation, Water, Sanitation & Hygiene (WASH), Surveillance & Reporting, Use of Oral Cholera Vaccines (OCV), Healthcare System Strengthening, and Community Engagement.
Ethiopia has historically faced recurrent cholera outbreaks due to poor sanitation, unsafe water, and weak health infrastructure. The plan prioritizes high-risk areas (hotspot woredas) and aims to reduce cholera-related mortality by 90% by 2028. It includes efforts to improve WASH conditions, strengthen disease surveillance, enhance rapid response capabilities, expand vaccination campaigns, and integrate cholera control into broader health policies.
The government, in collaboration with international partners such as WHO, UNICEF, and the Global Task Force for Cholera Control (GTFCC), will implement and monitor the plan. The estimated budget for the initiative is $390 million over eight years. Ethiopia aims to achieve zero cholera transmission in hotspot regions, ensuring sustainable public health improvements.
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Response to the Periodic EpidemicThe document "Zanzibar's Victory Against Cholera Epidemic" details the successful efforts taken by Zanzibar to control and eliminate cholera outbreaks. It highlights the strategies implemented, including improved
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water and sanitation infrastructure, public health campaigns, vaccination programs, and rapid response measures. The report emphasizes community engagement, government commitment, and international partnerships as key factors in combating the disease. Zanzibar's experience serves as a model for other regions facing similar public health challenges, demonstrating that sustained efforts in hygiene, disease surveillance, and emergency preparedness can effectively control cholera epidemics.
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On Global Handwashing Day, WHO and UNICEF have released the first-ever global Guidelines on Hand Hygiene in Community Settings to support governments and practitioners in promoting effective hand hy
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giene outside health care – across households, public spaces and institutions. Framing hand hygiene as a public good and a government responsibility, the Guidelines translate evidence into ready-to-adopt actions that enable sustainable access to effective hygiene services. This will reduce diarrhoeal disease, acute respiratory infections and other preventable illnesses, strengthening routine public health where people live, work, visit and study, and emergency preparedness, including outbreaks like cholera.
Despite clear benefits, 1.7 billion people still lacked basic hand hygiene services at home in 2024, including 611 million with no facility at all. Meeting the 2030 target will require accelerated progress – about a doubling in the global rate, and much faster in specific settings (up to 11-fold in least-developed countries and 8-fold in fragile contexts). Hand hygiene remains one of the most cost-effective health investments, reducing diarrhoea by 30% and acute respiratory infections by 17%, with large, measurable gains for population health.
“Clean hands save lives, but results at scale require policy, financing and accountability,” said Dr Ruediger Krech, Director a.i, Department of Environment, Climate Change, One Health & Migration at the World Health Organization. “These Guidelines help countries move beyond fragmented projects to government-led systems that make soap, water, and conditions conducive to everyday hand hygiene the norm.”
“Children and young people pay the highest price when basic hygiene is out of reach,” said Cecilia Scharp, Director, Water Sanitation and Hygiene (WASH) Team, Programme Group, UNICEF. “These Guidelines provide practical steps to ensure facilities are accessible when they need to be – in homes, schools, markets, and transport hubs – so every child can learn, play and thrive with dignity.”
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Undernutrition in Myanmar. Part 2: A Secondary Analysis of LIFT 2013 Household Survey Data
Zaw Win; Cashin, Jennifer
Leveraging Essential Nutrition Actions to Reduce Malnutrition (LEARN)
(2016)
C1
In order to better understand the contributing factors of undernutrition in LIFT program areas and the links between child nutritional status and independent variables of programmatic importance to
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LIFT (such as income, livelihoods, food security, and water, sanitation and hygiene [WASH]), LEARN commissioned a secondary analysis of nutrition-related data from the 2013 LIFT Household Survey. The purpose of this report is to present the findings of this analysis.
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Trachoma is a bacterial eye infection found in poor, isolated communities lacking basic hygiene, clean water, and adequate sanitation.
The PDF "Vamos proteger-nos da Cólera" provides comprehensive guidance on cholera prevention and response strategies, particularly for use in community health settings. It emphasizes the importance of safe
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water use by treating water with bleach, boiling it for at least 5 minutes, or using purification tablets like Aquatabs. Handwashing is highlighted as a key measure, especially after using the latrine, before preparing food, and before eating. Sanitation practices include using and maintaining clean latrines or, if unavailable, burying feces far from homes and water sources.
The document also addresses diarrhea treatment, recommending the preparation and use of Oral Rehydration Solution (ORS) with added zinc for effective recovery. It encourages breastfeeding for infants with diarrhea and stresses the importance of cooking food thoroughly, keeping it covered, and ensuring all utensils and surfaces are clean. Proper waste management, including the disposal of household waste, is highlighted to maintain a clean and safe environment.
In emergency situations, the guide advises seeking immediate medical attention for severe diarrhea and emphasizes the prompt burial of bodies during outbreaks to prevent contamination. Additionally, it provides visuals and strategies for community engagement, empowering health workers and communities to promote awareness and adopt effective cholera prevention measures.
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The Lancet Global Health, published online 18 August 2017;
http://dx.doi.org/10.1016/S2214-109X(17)30332-7
The article "The Political Determinants of the Cholera Outbreak in Yemen" examines how the ongoing civil war has contributed to Yemen’s severe cholera outbreak. The 2017 epidemic was des
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cribed as the worst in the world, with cholera spreading rapidly due to the collapse of health, water, and sanitation systems.
The analysis shows that Houthi-controlled areas were disproportionately affected, accounting for 77.7% of cases and 80.7% of deaths. The article highlights the role of the Saudi-led coalition in worsening conditions through airstrikes on infrastructure, blockades restricting medical and food supplies, and the overall humanitarian crisis. It criticizes UNICEF for accepting a $67 million donation from Saudi Arabia while the coalition contributed to the crisis.
The article underscores that political actions and conflict have been key factors in the outbreak’s severity, with both warring sides failing to protect civilians.
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In 2015, 5.9 million children under age five died (1). The major causes of child deaths globally are pneumonia, prematurity, intrapartum-related complications, neonatal sepsis, congenital anomalies, diarrhoea, injuries and malaria (2). Most of these
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diseases and conditions are at least partially caused by the environment. It was estimated in 2012 that 26% of childhood deaths and 25% of the total disease burden in children under five could be prevented through the reduction of environmental risks such as air pollution, unsafe water, sanitation and inadequate hygiene or chemicals.
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(August 28 – October 10, 2017)
A nutrition and mortality assessment using SMART methodology was applied and the survey covered 15 statistical (14 districts plus 1) domains countrywide. The ma ... in objective of the survey was to assess the current nutrition status of the population, especially children 6-59 months old and women of reproductive age (15-49 years of age). The survey also looked at the major contextual factors contributing to undernutrition such as infant and young child feeding (IYCF) practices; food security indicators; water, sanitation and hygiene indicators; and health situation in Sierra Leone more
A nutrition and mortality assessment using SMART methodology was applied and the survey covered 15 statistical (14 districts plus 1) domains countrywide. The ma ... in objective of the survey was to assess the current nutrition status of the population, especially children 6-59 months old and women of reproductive age (15-49 years of age). The survey also looked at the major contextual factors contributing to undernutrition such as infant and young child feeding (IYCF) practices; food security indicators; water, sanitation and hygiene indicators; and health situation in Sierra Leone more
In many humanitarian emergencies, there is a serious lack of access to even the most basic materials needed for managing the blood in addition to a lack of appropriate sanitation facilities (including wat
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er), which are critical for addressing menstrual hygiene. Privacy in emergencies is often scarce, and even if toilets are available they often lack locks, functioning doors, lighting and separation between genders. These barriers are often intensified by cultural beliefs and taboos surrounding menstruation which can restrict the movements and behaviors of girls and women
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The WHO/UNICEF JMP report, WASH in Health Care Facilities, is the first comprehensive global assessment of water, sanitation and hygiene (WASH) in
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health care facilities. It also finds that 1 in 5 health care facilities has no sanitation service*, impacting 1.5 billion people. The report further reveals that many health centres lack basic facilities for hand hygiene and safe segregation and disposal of health care waste.
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