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Après plus de trois ans sans cas, Haïti a signalé le 2 octobre 2022 un ensemble de cas de choléra dans la zone métropolitaine de Port-au-Prince, alors que le pays était sur le point d'être déclaré exempt de choléra.
Cette résurgence du choléra en Haïti survient dans un contexte opérat
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ionnel complexe, au milieu d'un environnement socio-politique instable marqué par des blocus, des pénuries de carburant, des activités de bandes criminelles et une insécurité galopante. Les troubles civils et le manque d'accès aux communautés touchées aggravent la crise humanitaire complexe et entravent les efforts de réponse d'urgence.
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After more than three years without cases, Haiti reported on 2 October 2022 a cluster of cholera cases in the metropolitan area of Port-au-Prince, just as the country was on the verge of being declared cholera- free.
This cholera resurgence in Haiti is happening in a complex operational context, am
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id a volatile socio- political environment marked by blockades, fuel shortages, criminal gang activity and rampant insecurity. Civil unrest and lack of access to the affected communities are deepening the complex humanitarian crisis and hindering emergency response efforts.
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The Transformation Agenda (TA) ushered in an ambitious reform process intended to transform the World Health Organization (WHO) into an organization that is proactive, results-driven, accountable and which meets stakeholder expectations, towards transforming and improving public health services in t
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he African Region. It aimed to achieve a WHO that is pro-results, which optimally and creatively targets technical work as well as make operations more responsive, with greater effectiveness in both communications and partnerships. The Africa Region has been the epicentre of the human immunodeficiency virus (HIV) epidemic and it’s one of the leading causes of disease and death on the continent. The WHO, with partners, has worked tirelessly for many years to control the threat and reduce the negative impact of the disease. Since the early 2000s, significant progress has been made in the global fight against the scourge of HIV. However, the WCA subregion was falling concerningly behind ESA on several key indicators of progress. In 2016, the WHO joined UNAIDS, UNICEF and other partners in a call for a strong and urgent response to support WCA countries to develop catch-up plans to triple and fast-track ART coverage, to enable the region to catch up with ESA by the end of 2020. Implementation of a widespread test-and-treat strategy, coupled with the scale-up of differentiated service delivery (DSD) and mobilization of requisite funding, accelerated WCA’s progress towards this goal. The HIV treatment catch-up and fast-track plan has achieved its target of seeing the West and Central African region (WCA) catch up with the Eastern and Southern African region’s (ESA) antiretroviral coverage rate of 78% in 2021, albeit later than the 2020 target time frame. A 33% improvement was achieved in WCA, against 21% in ESA, between 2015–2020. WCA achieved a significant 42% increase, compared to ESA’s 23%, between 2015 and 2021, to see WCA draw level with ESA at 78%. In the Democratic Republic of the Congo (DRC) alone, progress of up to 47% was observed between 2015 and 2020, for example. In addition, 1.6 million more People Living with HIV (PLHIV) were enrolled on antiretroviral treatment (ART) between 2015 and 2020.
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Le document fournit des directives essentielles pour prévenir et gérer les maladies diarrhéiques aiguës, en particulier dans les situations d'urgence complexes comme les conflits, les catastrophes naturelles ou les crises sanitaires. Il met en avant l'importance de l'accès à l'eau potable, de
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l'assainissement, de l'hygiène personnelle et de la prise en charge rapide des malades grâce à des solutions de réhydratation orale (SRO). Le texte insiste également sur la nécessité de la coordination entre les acteurs locaux et internationaux pour une réponse efficace et durable.
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The CDC report on Preventing Diarrheal Disease in Developing Countries highlights five effective household water treatment methods to reduce waterborne illnesses, which cause millions of deaths annually. These methods include ceramic filtration, solar disinfection (SODIS), flocculant/disinfectant po
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wder (PUR), household chlorination, and slow sand filtration. Each method varies in effectiveness, cost, and ease of use, with benefits such as pathogen removal, affordability, and scalability, but also challenges like maintenance, recontamination risks, and user acceptance. The report emphasizes the importance of safe water storage and education to maximize health benefits.
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Our duty of care
Abdul Rahim, H.F.; M. Fendt-Newlin, S. T. Al-Harahsheh, et al.
Quatar Foundation; Wolrd Innovation Summir ofr Health WISH
(2022)
CC
A global call to action to protect the mental health of health and care workers
The South African Department of Health reports a decline in cholera cases, with only one confirmed case out of 28 suspected cases in the last 10 days as of July 5, 2023. However, authorities urge continued vigilance, emphasizing hygiene, especially during mass gatherings.
Since February 2023, South
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Africa has recorded 1,073 suspected cholera cases, with 198 confirmed cases across five provinces. Gauteng Province is the most affected, with 176 cases, primarily in Hammanskraal, Tshwane. Other affected provinces include Free State, North West, Limpopo, and Mpumalanga.
The outbreak has resulted in 47 deaths, with four new suspected deaths reported in the Free State. The majority of confirmed cases are in individuals aged 41-50 years, and 52% of cases are female.
The health department continues preventive efforts through health education and targeted case-finding. Authorities also stress the importance of clean water and hygiene compliance in initiation schools to prevent further outbreaks.
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760 WEEKLY EPIDEMIOLOGICAL RECORD, NOS. 51/52, 20 DECEMBER 2024, pp.760-769. In French and English
The WHO Cholera Rapid Diagnostic Test (RDT) Target Product Profile outlines the key requirements for developing improved cholera RDTs. It highlights the need for fast, accurate, and easy-to-use tests for early outbreak detection in resource-limited settings. The document sets desired and acceptable
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performance criteria, including high sensitivity and specificity, rapid results (under 15 minutes), and usability by non-laboratory personnel. The tests should be affordable, stable in extreme conditions, and require minimal training. The goal is to enhance cholera surveillance and outbreak response, ensuring quick containment and improved public health outcomes.
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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
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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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Mozambique was the first country outside of the Sahel to successfully implement seasonal malaria chemoprevention (SMC) on a large scale. This learning paper captures some of the lessons drawn from the implementation process.
Dans certaines parties d’Afrique, la transmission du paludisme a lieu principalement pendant les trois ou quatre mois de la saison des pluies. Environ 39 millions d’enfants de moins de cinq ans vivent dans les zones de transmission saisonnière, où on dénombre environ 34 millions de cas et où
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plus de 150.000 enfants meurent chaque année. La CPS est une intervention préventive ciblant spécifiquement les enfants vivant dans ces régions. La CPS, appelée autrefois traitement préventif intermittent chez l’enfant, est « l’administration intermittente d’un traitement complet par un médicament antipaludique pendant la saison du paludisme afin de prévenir la
maladie, avec pour objectif de maintenir les concentrations sanguines du médicament antipaludique à des taux thérapeutiques pendant toute la période où le risque de paludisme est le plus élevé. »
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Issued by the Ministers of Health of High Burden High Impact (HBHI) countries in Africa. Yaounde Declaration.
Ministers committed to strengthening their health systems, stepping up domestic resources, enhancing multisectoral action and ensuring a robust accountability mechanism,” notes Dr Daniel
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Ngamije, Director of the WHO Global Malaria Programme. “This is the kind of leadership the world must rally behind.
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World malaria report 2025. Excecutive Summary
recommended
Addressing the threat of antimalarial drug resistance. This year’s report spotlights the growing threat of antimalarial drug resistance. Partial resistance to artemisinin derivatives – the backbone of malaria treatments after failures of chloroquine and sulfadoxine-pyrimethamine – has now b
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een confirmed or suspected in at least 8 countries in Africa, and there are potential signs of declining efficacy of some of the drugs that are combined with artemisinin.
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The document is a policy brief by the NCD Alliance for the 2023 United Nations High-Level Meeting on Universal Health Coverage (UHC). It highlights the importance of integrating non-communicable diseases (NCDs) into UHC efforts, with the goal of ensuring equitable health access worldwide.
This document aims to provide Ministry of Health guidance on the implementation of PEP and PrEP to prevent HIV transmission and improve overall health outcomes. This comprehensive approach reflects the commitment of all involved in combating HIV and enhancing public health.
On 19 August 2016, the former UN Secretary-General announced a new approach to cholera in Haiti, consisting of two tracks. Track 1 focuses on reducing cholera transmission, improving access to care, and addressing water, sanitation, and health system issues. Track 2 aims to provide material assistan
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ce to those most affected by cholera. The Secretary-General urged Member States to show solidarity with Haiti by increasing contributions. The UN General Assembly, in resolution 71/161, recognized the UN's moral responsibility to cholera victims and called for support to eliminate cholera and address its victims' suffering. The Secretary-General was requested to provide an update on the progress of this approach.
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Social and Behavior Change Communication for Emergency Preparedness Implementation Kit
Amrita Gill-Bailey, Kathryn Bertram, Uttara Bharath et al.
Johns Hopkins University and US Agency for International Development (USAID)
(2017)
C1
Each unit builds on the one prior, and they all combine to provide key information for developing an SBCC strategy. It is not essential, however, to work through the I-Kit from start to finish. Users can choose to focus on specific aspects for which they need support in their emergency communication
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response. The nine units and corresponding worksheets are outlined in the I-Kit Site Navigator.
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The WHO Guide on Oral Cholera Vaccines in Mass Immunization Campaigns provides guidance on the planning and implementation of oral cholera vaccine (OCV) campaigns. It covers key aspects such as when and where to use OCVs, vaccine specifications, and recommendations for use in endemic areas, outbreak
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settings, and complex emergencies. The document outlines steps for macro- and micro-planning, logistics, budgeting, human resource allocation, and risk communication. It also highlights challenges, including cold chain management, vaccine supply, and community engagement, ensuring that vaccination campaigns are efficient and effective in reducing cholera outbreaks.
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The technical note from the Global Task Force on Cholera Control (GTFCC) examines the risks and benefits of vaccinating pregnant women with WHO-prequalified oral cholera vaccines (OCVs) during mass vaccination campaigns. It highlights that three WHO-approved vaccines (Dukoral®, Shanchol™, and Euv
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ichol®) offer sustained protection and a strong safety profile.
While these vaccines are not explicitly contraindicated for pregnant women, there is limited clinical data on their use during pregnancy. However, studies indicate that pregnant women with cholera face higher risks of fetal loss, stillbirth, and complications, especially if they experience severe dehydration. Some evidence suggests that vaccination can reduce cholera incidence in pregnant women and indirectly protect infants.
Although no controlled trials have focused on pregnant women, retrospective studies in Guinea and Zanzibar showed no significant increase in adverse pregnancy outcomes after OCV administration. The GTFCC concludes that the benefits of vaccination outweigh the risks, particularly in high-risk areas, and recommends including pregnant women in cholera vaccination campaigns while continuing to monitor safety data.
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