Cholera

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Dr. Asha Mohammed: From dentist to humanitarian leader, her passion and leadership now focused on Africa’s biggest challenges

Dr. Asha Mohammed began her career as a dentist in low-income communities in Kenya. Her passion for helping others and her evident leadership skills led her to key roles battling HiV/AIDS and, eventually, to the role of Secretary General of the Kenya Red Cross. She now serves as IFRC’s Permanent Representative to the African Union and International Organizations in Addis Ababa, Ethiopia. From there, she’s taking on climate change, a massive regional hunger crisis, and outbreaks of infectious diseases, among other challenges. In this episode, she talks about the solutions to those challenges. And what it was like being a pioneering woman leader in public health. “When I mentor young women, I tell them, ‘You can be what you want to be. It's really about understanding that you have these different roles to play and that you can find the right balance.”

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World Red Cross and Red Crescent Day: How a vigilant volunteer helped thwart an emerging cholera outbreak

The city of Tog Wajaale, perched on the Somaliland-Ethiopia border, serves as a crucial crossing point for people and goods, particularly those coming and going from the port of Berbera, located about 300 kilometers away on the Gulf of Aden.It is also a place where an outbreak of any infectious disease could travel quickly — and far — because of the high levels of commerce and people passing through.That’s one reason the swift action of a Red Crescent community health volunteer Nimao Abdi Bade was so critical during the first days of a cholera outbreak in January 2024.Spotting a family with severe symptoms, Nimao recognized the signs and reported their case via a platform managed by the Somali Red Crescent Society (SRCS), which then triggered a swift official response from health authorities.It turned to be the first reported case ofacute watery diarrhoea (AWD) and cholera in Somaliland and it led to a combined and coordinated response that greatly reduced the impact of the outbreak.A vigilant volunteerNimao's vigilance didn't stop at the first case. Tracing the family's contacts, she uncovered more potential cases involving people who had recently crossed the border. This led to confirmation of several cholera cases and a Ministry of Health intervention.Trained by SRCS to identify and reportcases ofacute watery diarrhoea (AWD) and cholera and inspired by her success, she urged others to report illnesses promptly."AWD/Cholera was new to us," Nimao says. "But SRCS training equipped us to respond. I am so proud of myself and being a volunteer of SRCS."The outbreak prompted SRCS to deploy more volunteers for house-to-house visits and hygiene promotion.Nimao's commitment went beyond initial reporting. During her house-to-house visits, she identified five additional cross-border cases, promptly reporting them. These reports, verified by SRCS Community Health Officer Roda Mohamoud Mohamed, led to further investigations. The following day, six more suspected cases were reported and escalated to the Ministry of Health.Empowered by her success, Nimao has become a champion for timely reporting and community-based surveillance. Her diligence exemplifies the vital role volunteers play in strengthening public health responses.SRCS also responded by mobilizing volunteers in Wajaale, another town on the Ethiopian-Somaliland border, and the surrounding areas, as well as the nearby Marodijeh region. The focus shifted to house-to-house visits, hygiene promotion, and raising community awareness about AWD/Cholera risks and prevention.

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World Health Day 2024

Everyone, everywhere should have access to good health care and the basic ingredients to a healthy life. The theme of World Health Day in 2024 is 'My Health, My Right', and we could not agree more. Access to health care is a basic human right. My health, my right also means a healthy environment, safe food and water, and strong community readiness for emergencies and epidemics. Sadly, access to those basic ingredients are under threat, due to conflict, climate events, natural calamity and extreme poverty. We invite you to join our ongoing efforts to help people around the world access this most basic of human rights.

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Zimbabwe: Bringing critical care directly to communities impacted by cholera

In the heart of Hopley Farm in Harare, a silent threat looms large - cholera.Zimbabwe was hit hard by a significant cholera outbreak that started in Chegutu town and quickly spread across the country in 2023. By November 7, over 6,000 suspected cases and 136 deaths were recorded, with weekly cases surpassing 500, marking the highest rate since the outbreak began.In response, the Zimbabwe Red Cross swung into gear, leading a comprehensive strategy focused on prevention, containment, and upscaling efforts at the community level in the most hard-hit places.One of the cornerstones was the establishment of Oral Rehydration Points (ORPs) strategically placed in Hopley Farm, providing vital oral rehydration therapy to those in need. Manned by dedicated volunteers, who also live in the community, these points of care became crucial in the fight against cholera.The recurring cholera outbreaks in informal settlements like Hopley in Harare underscore the peril of poverty and inadequate urban planning. With Hopley's population estimated at around 100,000 people, it's critical to have timely interventions and access to clean water to prevent cholera-related fatalities.“Initially the community did not believe that there was cholera,” says Fortune, a Zimbabwe Red Cross Volunteer leading the team at the ORP site in Hopley. “Even setting up the ORP site was a problem. But when the community started hearing about and seeing cases of cholera, the ORP site is where they would come to get information.”Cholera is an acute diarrheal illness caused by infection with vibrio cholerae bacteria. Approximately 1 in 10 people who contract cholera will experience severe symptoms such as watery diarrhea and vomiting. This rapid loss of body fluids leads to dehydration and shock, and without treatment, death can occur within hours.That’s why water — mixed with other ingredients that help the body retain water — is a critical element in treating those infected with the cholera bacteria.Bringing rehydration to hardest hit placesThe ORPs serve as the primary points of care and the first line of defense for community-level cholera case management through administration of oral rehydration therapy. Research has shown that 80 per cent of suspected cholera cases (mild to moderate) can easily be managed at community ORPs and may not need to visit a local health facility.This effectively decongests health facilities, reduces the transport burden on patients and save lives by providing quick treatment. It also saves lives because people from poor communities sometimes succumb to cholera due to delayed treatment as they often must travel long distances to health centers to get care.Lack of access to rapid treatment is particularly acute when the healthcare system its stretched thin by outbreaks, facing shortages of supplies and personnel, while authorities worked to contain the spread by urging caution against unsanitary gatherings.The impact has been tangible. Over 1,400 patients have been served at the ORPs in Harare, with many more receiving timely referrals for further treatment. Lives were saved, not just through medical intervention, but through the spread of knowledge and awareness.Information also saving livesBesides providing oral rehydration therapy, the ORPs also serve as information and reporting centers where patients get critical information about stopping cholera transmission and treatment and provide critical reports to health facilities about levels of infection and community readiness for response. ZRCS is looking at deploying more ORPs in Harare and beyond as they plan to scale up their response in-country.The project has also emphasized community involvement and empowerment. Volunteers conducted door-to-door visits, engaging residents in risk communication and education efforts, turning the community into active participants in their own health.Communities across the country struggled with limited knowledge and resources, fueling stigmatization, and making certain groups more vulnerable to the disease, especially in areas like Harare, Mutare, and Buhera.Knowledge about cholera prevention can also save lives and, again, water also plays a major role. Exposure to contaminated water or food is a leading cause of transmission while access to safe water — and safe use of water and proper hygiene practices — is the best way to stop the spread of cholera.At Hopley Farm, this combined approach — called the ‘Integrated Strategy for Cholera Risk Elimination and Mitigation’ — is supported by the European Union and the Finnish Red Cross and serves as a model for effective cholera risk mitigation beyond Hopley Farm.

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Joint statement: Millions at risk from cholera due to lack of clean water, soap and toilets, and shortage of cholera vaccine

Geneva/New York, 20 March 2024 – Immediate action is needed to stem an unprecedented multi-year upsurge in cholera cases worldwide, according to the International Coordinating Group (ICG) on Vaccine Provision. Actions include investing in access to safe water, sanitation and hygiene, testing and detecting outbreaks quickly, improving quality of and access to healthcare, and fast-tracking additional production of affordable oral cholera vaccine (OCV) doses to better prevent cases.The ICG manages the global cholera vaccine stockpile.The group includes the International Federation of Red Cross and Red Crescent Societies, Médecins Sans Frontières, UNICEF and WHO. Gavi, the Vaccine Alliance, finances the vaccine stockpile and the delivery of OCV. ICG members are calling for governments, donors, vaccine manufacturers, partners and communities to join in an urgent effort to halt and reverse the rise in cholera.Cholera has been surging globally since 2021, with the 473000 cases reported to WHO in 2022, more than double those reported in 2021.Preliminary data for 2023 reveal further increases, with over 700000 cases reported. Several of the outbreaks have high case fatality rates, exceeding the 1% threshold used as an indicator for early and adequate treatment of cholera patients. These trends are tragic given that cholera is a preventable and treatable disease and that cases had been declining in previous years. Cholera is an acute intestinal infection that spreads through food and water contaminated with faeces containing the bacterium Vibrio cholerae.The rise in cholera is being driven by persistent gaps in access to safe water and sanitation. Although efforts are being made to close these gaps in places, in many others the gaps are growing, driven by climate-related factors, economic insecurity, conflict, and population displacement.Safely managed water and sanitation are prerequisites for stopping the transmission of cholera.Currently, the most severely impacted countries include the Democratic Republic of the Congo, Ethiopia, Haiti, Somalia, Sudan, Syria, Zambia, and Zimbabwe.Now more than ever, countries must adopt a multisectoral response to fight cholera.Members of the ICG call on currently and potentially affected countries to take urgent steps to ensure their populations have access to clean water, hygiene and sanitation services, and the information critical to prevent cholera’s spread. The establishment of these services requires political will and investment at the country level.This includes creating capacity for early detection and response, enhanced disease detection, rapid access to treatment and care, and working closely with communities, including on risk communication and community engagement.The severe gap in the number of available vaccine doses, compared with the level of current need, puts unprecedented pressure on theglobal stockpile of vaccines. Between 2021 and 2023, more doses were requested for outbreak response than the entire previous decade.In October 2022, the ongoing vaccine shortage necessitated the ICG to recommend a single vaccine dose, down from a previous, long-standing two-dose regimen. Approximately 36 million doses were produced last year, while 14 affected countries registered a need for 72 million doses for a one-dose reactive strategy. These requests understate the true need. Preventive vaccination campaigns have had to be delayed to preserve doses for emergency outbreak control efforts, creating a vicious cycle. The change in strategy enabled available vaccines to protect more people and respond to more cholera outbreaks amid the ongoing supply shortfall, but a return to a two-dose regimen and a resumption of preventive vaccination would provide longer protection.Global production capacity in 2024 is forecast to be 37-50 million doses but will likely continue to be inadequate to serve the needs of millions of people directly affected by cholera.Only one manufacturer, EuBiologics, currently produces the vaccine; while the company is doing its utmost to maximize output, more doses are needed. Currently, new manufacturers are not expected to join the market before 2025; they must be fast-tracked. The same urgency and innovation that we saw for COVID-19 must be applied to cholera.Additional manufacturers planning to enter the market need to accelerate their efforts and make doses available at affordable prices.We appeal to vaccine manufacturers, governments, donors and partners to prioritize an urgent scale-up of vaccine production, and to invest in all the efforts needed to prevent and control cholera.About the ICGPress release on dosing strategyGlobal task force on cholera controlIFRC on choleraUNICEF: cholera is endangering children globallyWHO on the cholera upsurge, including monthly situation reportsMedia contactsIFRC Email: [email protected]: Lukas Nef,Mobile: +41792400790Email: [email protected]: Sarah Al Hattab, UNICEF in New YorkTelephone: +1 917-957-6536Email: [email protected] Media TeamEmail: [email protected]

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Cholera: Outbreak silences a once vibrant town in southwestern Zimbabwe

Where children would normally be playing, it is now quiet on the streets of Mapanza, a small village in the southwest of Zimbabwe. The communal gatherings for meals have ceased, laughter is absent, and everyday clothing has been replaced by rain boots and protective suits.The village is grappling with a relentless cholera outbreak, starkly highlighting the severity of the disease.On a recent day of heavy rains, puddles surround the three large tents in the middle of the village. Medical personnel with masks and gloves move in and out of the tents. IV drips are carried into the tent where the most critical patients lie.In the other two tents, health workers attend to patients whose conditions have stabilized. Occasionally, a curious child peeks out from the tent. She appears to be about five years old.As we walk further into the village, we encounter Alec. "It likely started at a church service where many people gathered," says Alec, friendly and energetic man who lives in the village and who personally experienced how quickly cholera can strike without mercy. "Shortly after that, people started getting sick."Sources of contaminationIn addition, the community shares one water source, which got contaminated. Since cholera easily spreads through water, nearly half of the village was estimated to have fallen ill. There are no healthcare facilities in the area, exacerbating the situation to a critical level within hours.People were lying on the ground with nowhere to go, Alec recalls. "People started experiencing severe diarrhea and vomiting profusely,” he said. “Almost half of the compound population was down, and a local couple tried to ferry as many people as possible to the hospital in Chiredzi, but it was overwhelming. The worst affected were children and women; people also died." Alec also had to fight for his life. After he fell ill, his wife waited anxiously for news about her husband. She couldn't be with him and didn't know his condition. It was a nerve-wracking period.An immediate responseToday, when visitors come to the village, it's hard to grasp that this nightmare happened just a few weeks ago. While the events still loom large over the community, and things are still far from normal, fewer people are falling ill and very few are dying, thanks to those who mobilized to help.Volunteers from the Zimbabwe Red Cross Society (ZRCS) immediately supported the Ministry of Health and Child Care, bringing tents, medical supplies, and "oral rehydration solutions" so that people could be safely treated and no longer had to lie on the ground. Together with the Ministry of Health, they were able to control the outbreak.Even now, volunteers are everywhere in the village. Many of them, such as Alec's wife, are community members who volunteered after experiencing what cholera did to their loved ones. She now participates in door-to-door campaigns, informing people about how to protect themselves so that an outbreak of this magnitude does not happen again.Since the beginning of the outbreak, ZRCS volunteers and staff have been taking action to combat the spread of cholera and provide care for patients. The Red Cross has also been supporting the Ministry of Health in setting up a cholera treatment centre to allow individuals with symptoms of cholera access to appropriate care.Volunteers have also been visiting communities to inform people on how to protect themselves and their loved ones, as well as what to do if they become ill.To jumpstart the initial response, the IFRC's Disaster Response Emergency Fund (IFRC-DREF) allocated CHF 500,000 and soon after, the IFRC launched an emergency appeal seeking CHF 3 million in order to to reach more than 550,000 people with life-saving assistance and help to contain the outbreak.

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World Radio Day: How radio helps keep communities healthy and safe

Though we’re living in an increasingly digital world, radio remains an important source of information, entertainment, and connection in countries across the globe.This is especially true among rural communities, for whom radio is often the most trusted—or sometimes only—source of news and information for miles around.Imagine you’re living in one of these communities, far from the nearest health centre. You notice people are falling sick and you don’t know why. Seeking answers, you tune into your local radio station.The presenter is talking about the ‘mystery illness’ in a panicked way, saying how gruesome the symptoms are, how many people have died, and how you should avoid infected people at all costs. He’s heard the illness could be some kind of curse, and that apparently drinking salty water can protect you.Hearing this report, and with no other sources to turn to, you’d probably feel scared and unsure of what to do.But imagine you tuned in and heard a totally different show. The presenter calmly offers practical information about the disease—its name, symptoms, how it spreads, and measures you can take to protect yourself. He interviews a local doctor you know and trust who responds to common questions and concerns.You’d feel reassured and have the information you need to keep you and your family safe.In several countries, the IFRC and our National Societies are partnering with local media to do exactly this: provide life-saving information before, during, and after health outbreaks.As part of the Community Epidemic and Pandemic Preparedness Programme (CP3), we’ve been working with the charity BBC Media Action to train journalists and Red Cross Societies from seven countries in Lifeline Programming: special media programming that provides accurate, practical, and timely information in a health or humanitarian crisis.National Societies regularly partner with media outlets to broadcast helpful information that keeps communities healthy and safe from a wide range of diseases. Let’s look at some examples.KenyaIn Bomet and Tharaka Nithi counties, Kenya Red Cross teams up with local radio stations and county health services, reaching hundreds of thousands of people with useful health messages on how to prevent diseases such as anthrax, rabies and cholera.Information is shared in simple language. And listeners can call in to ask questions or suggest health topics for discussion.“At first, media was known for reporting two things, maybe: politics, and bad things that have happened in society. But the Red Cross helped us […] use the media in educating the people about disease,” explains Sylvester Rono, a journalist with Kass FM trained in Lifeline programming.“I am now proud to say that this has really helped our communities. Our people are now appreciating why we should vaccinate our pets, why we should go to the hospital when we have a bite, why we should report any [health] incident, and when you see any sign of diseases, be it rabies, be it anthrax, be it cholera […] the importance of reporting it earlier,” he adds.CameroonIn late 2021, a cholera outbreak threatened the lives of communities in the North region of Cameroon—a rural part of the country where communities are widely dispersed.As part of its response, the Cameroon Red Cross teamed up with local radio stations—launching a series of community radio programmes to share information on how people could protect themselves, what symptoms to look out for, and where to access help if they fell sick.Themes for the programmes were selected in partnership with community leaders. And after the shows broadcast, Red Cross volunteers headed out into their communities to reinforce the messages shared on air through door-to-door visits.“The radio programme is very good, because it has given me practical information. I had a cholera case in my family, but based on the measures I heard on the radio, I was able to save my sister’s child who was sick,” explained Talaga Joseph, a listener who called into FM Bénoué—one of the participating radio stations.Democratic Republic of the Congo (DRC)In DRC, harmful rumours and misinformation about COVID-19 and other diseases have spread across the country in recent years. For example, some people believed the COVID-19 vaccine was a source of income for the government and had no benefit to society, while others believed the measles vaccine was less effective than traditional remedies involving cassava leaves.To address these rumours, DRC Red Cross volunteers went door-to-door to collect community feedback and record common myths and misconceptions. After analysing the feedback, DRC Red Cross staff took to the airwaves—launching interactive radio shows to directly address and debunk health misinformation and provide trusted advice.For example, in Kongo Central province, the DRC Red Cross partners with Radio Bangu to produce a show called ‘Red Cross School’. Listeners call in to check information on different diseases, ask questions, and discover what support they can access from the Red Cross.“The collaboration with the Red Cross is very good and has enabled listeners to learn more about its activities and how they can prevent different illnesses and epidemics. The Red Cross broadcasts are so popular they have increased our overall number of listeners in the area we cover,” says Rigobert Malalako, Station Manager at Radio Bangu.--The activities with local radio featured in this article are just a few examples of media partnerships developed through the Community Epidemic and Pandemic Preparedness Programme (CP3).Funded by the U.S. Agency for International Development (USAID), CP3 supports communities, Red Cross and Red Crescent Societies, and other partners to prevent, detect and respond to disease threats.If you enjoyed this story and would like to learn more, sign up to the IFRC’s Epidemic and Pandemic Preparedness Newsletter.You can also access the following resources:BBC Media Action’s Guide for the media on communicating in public health emergencies (available in multiple languages)BBC Media Action’s Lifeline programming websiteIFRC Epidemic Control Toolkit

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A deadly start to 2024: Cholera in Zimbabwe spreads rapidly after holiday season

Almost a year ago, the first patient with cholera in Zimbabwe was reported in the town of Chegutu, located about 100 kilometres southwest of the capital Harare. Throughout 2023, the numbers have only increased, as the disease spread to all the country’s ten provinces. During the recent holiday period, there was an additional steep increase as people travelled and gathered to celebrate with their extended families, giving the disease new opportunities to spread. “Our worst fears and predictions for the post-holiday season are confirmed with this upward trend of people contracting cholera," says John Roche, head of IFRC's Country Cluster Delegation for Zimbabwe, Zambia and Malawi.“This is especially worrisome for people with vulnerable health, who are the most affected and urgently need assistance.” "With schools starting again and people going back to work, we must act quickly to reduce the numbers now. We have no time to lose; we need to break the cycle as every life in jeopardy is one too many.” No time to lose For this reason, speed is of the essence. Cholera spreads rapidly and easily. Simply drinking or eating something infected with the cholera bacteria can result in infection. This can lead to severe diarrhea and vomiting, sometimes so intense that people lose litres of water per day. The dehydration that followed can lead to death if measures are not put in place to rehydrate quickly. In the capital city, many people live in close quarters and hygiene measures are poor, increasing the risk of becoming ill. With thousands of suspected cholera cases in the capital, Harare has declared a state of emergency. Additionally, sewage and water infrastructure in many places in the country are in dilapidated condition requiring major rehabilitation. Sewage blockages are common, contributing to the rapid spread of the disease. Moreover, people struggle to access clean water for cooking and drinking. Red Cross ready to help Since the beginning of the outbreak, volunteers, and aid workers from the Zimbabwe Red Cross Society (ZRCS) have been taking action to combat the spread of cholera and provide care for patients. Volunteers have been visiting communities to inform people on how to protect themselves and their loved ones, as well as what to do if they become ill. ZRCS has also been supporting the Ministry of Health in setting up Cholera treatment to allow individuals with symptoms of cholera access to appropriate care. A total of nine Oral Rehydration Points (ORPs) have been set up throughout the country (in Harare, Mutare district, Masvingo district and Mashonaland). These locations were chosen based on the presence of trained volunteers conducting door-to-door cholera awareness sensitization. A community feedback mechanism has been setup and there are currently community feedback meetings and suggestion boxes at numerous health facilities. So far, community outreach volunteers have connected and shared information with over 171,000 people. To ensure that Red Cross teams can act promptly, the IFRC’s Disaster Response Emergency Fund (IFRC-DREF) allocated roughly 500,000 in June 2023 to support immediate response efforts. Unfortunately, cholera spreads rapidly, and ZRCS needs more funds to ensure that the number of infected individuals reaches zero. For this reason, the IFRC and its members are urging people to support its emergency appeal seeking CHF 3 million to support the ZRCS reach 550,455 people with life-saving assistance and help to contain the outbreak. “This support is vitally needed to combat cholera and help ensure that no more lives are lost to this disease,” says IFRC’s Roche.

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Zambia: Cholera Outbreak

A cholera outbreak in Zambia, first reported in October 2023, has seen a dramatic increase in transmission since mid-December. The country has now recorded more than 7,000 cases and 270 deaths, with over 500 new cases daily. The IFRC and its membership seek CHF 4 million (CHF 3 million of which is expected to be raised by the IFRC Secretariat) to support the Zambia Red Cross Society to reach 3.5 million people with life-saving assistance.

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Cholera outbreak spirals in Zambia: IFRC launches urgent CHF 4 million appeal

Geneva/Nairobi/Lusaka, 15 January 2024: Responding to a severe cholera outbreak in Zambia, the International Federation of Red Cross and Red Crescent Societies (IFRC) has launched an emergency appeal for 4 million Swiss Francs. This fund is aimed at supporting the Zambia Red Cross Society, in its auxiliary role to Zambia’s Ministry of Health, to mitigate the impact of the outbreak on affected communities and prevent further spread.In October 2023, a new cholera outbreak was reported and has seen an increase in transmission since mid-December, putting over 10 million people at risk. The outbreak initially emerged from peri-urban areas of Lusaka province, where most of the cases are being reported. Due to the high rate of transmission, the disease is now affecting people across multiple geographical areas. Nine out of ten provinces have reported cases of cholera, with six provinces confirming cholera outbreaks.John Roche, IFRC Head of Delegation Country Cluster for Zimbabwe, Zambia, and Malawi, said:“To ensure no more lives are lost, we must prioritize access to clean and safe water. With the waterborne disease spreading rapidly, we are deeply concerned about the situation unfolding. The IFRC and Zambia Red Cross Society are seeking resources to contribute to activities that can support stopping the spread and its transmission.”Cosmas Sakala, Acting Secretary General of Zambia Red Cross Society, said:“With increased rains and possible flooding, the cholera outbreak could escalate, and we fear that many more lives would be lost. Zambia Red Cross requires more resources to support the government in scaling up interventions such as Risk Communication and Community Engagement, enhancing access to safe water and sanitation to curtail the epidemic, and improving community case management to reduce fatalities.”In response to the outbreak, the IFRC has allocated CHF 750,000 from its Disaster Response Emergency Fund (DREF) to support relief efforts. Zambia Red Cross Society staff and volunteers have been mobilized and are supporting cholera response activities through door-to-door visits, setting up Oral Rehydration Points where people showing signs of cholera can be rehydrated, spreading hygiene messages, and carrying out community sensitizations on cholera prevention and control. This commencement of public health education is being done in collaboration with Zambia’s Ministry of Health and UNICEF.To continue the response, a total of CHF 4 million is needed and will support 3.5 million people.Last year, the neighbouring country of Malawi faced one of its worst cholera outbreaks in years. Additionally, Zimbabwe is currently battling a cholera outbreak that is resulting in daily loss of lives. The IFRC remains committed to halting the spread of cholera in Zambia, ensuring that affected populations receive necessary care and support.More information:To learn more or support the appeal, visit our page by clicking on the link.To request an interview, contact:[email protected] Nairobi:Anne Macharia: +254 720 787 764In Geneva:Tommaso Della Longa: +41 79 708 43 67Mrinalini Santhanam +41 76 381 5006

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Off the radar: Ten disasters of 2023 you’ve likely never heard of

Maybe it's because the disaster happened in a remote, rural area, far from media hubs. Maybe it’s “too small” to warrant a global reaction. Whatever the reason, some emergencies don't get as much attention as others. For the people living through these crises, however, they are just as real, heartbreaking and life-changing as the big catastrophes that go viral or that benefit from the ‘CNN effect’. And when you’ve lost your home to a flood, fire or landslide – or you’ve had to leave town with nothing but the clothes on your back – you don’t have time for the world to catch on. This is why the IFRC has a rapid-response funding mechanism called the Disaster Response Emergency Fund (IFRC-DREF) that gets funds quickly to all crises, large or small. Here are ten of the least-known disasters that IFRC-DREF responded to in 2023. 1. El Nino in Ecuador In the later half of 2023, extreme rainfall generated by the El Niño phenomenon on the Ecuadorian coast caused rapid flooding. Fortunately, affected communities were more prepared than in the past thanks to actions they took ahead of the rains. When the El Nino’s impacts were first forecast, government agencies declared that preparing for and preventing damage from the expected heavy rains was a national priority. For its part, the IFRC-DREF allocated funds to ensure 1,000 at-risk families would have safe drinking water, proper waste management, food set aside and many other precautionary measures. 2. Cholera outbreak in Zimbabwe Like many other relatively localized or regional epidemics, the cholera outbreak in Zimbabwe in 2023 has received little international attention. It started in February 2023 and to date, suspected and confirmed cases have been reported in 41 districts in all the country’s 10 provinces. The IFRC has launched an emergency appeal to support the work of the Zimbabwe Red Cross, but even before that, IFRC-DREF dispersed CHF 500,000 to support 141,257 people with health care and water, sanitation and hygiene support in key impacted areas. The goal is to prevent and control the spread of Cholera, interrupt the chain of transmission, facilitate the improvement of case management and improve basic sanitation, hygiene practices and access to safe drinking water. 3. Floods in Bosnia-Herzegovina The northwestern area of Bosnia and Herzegovina experienced intense rainfall in mid-May 2023, causing widespread flooding and extensive damage to people’s houses and local infrastructure. The floods also destroyed crops and rendered much farmland and dairy production inoperable. It was a severe blow to one of the lowest-income areas in Europe, a region that relies on local agriculture for sustenance and income. IFRC-DREF allocated CHF 126,504 to the Bosnian Red Cross to support 1500 people through a variety of assistance measures, including cash transfers, distribution of essential equipment and hygiene supplie, and dissemination of health information, among other things. 4. Storms and floods on top of drought and conflict Sometimes disasters are hidden by the larger crisis enveloping a particular region. The scale of the humanitarian suffering in Yemen is so massive and widespread, there was little notice of the tropical cyclone that hit the country in October 2023. Tropical Cyclone Tej made landfall over the southern coast of Al Mahrah Governorate on the night of 23 October and continued to move northwestward. The cyclone caused widespread flooding, infrastructure destruction, displacement of communities, and the loss of many lives. IFRC-DREF quickly supported the response of Yemen Red Crescent with CHF 281,000 to support internally displaced people, host communities, returnees, marginalized groups, and migrants/refugees. 5. Fires in Chile In Febuary 2023, strong winds and high temperatures caused dozens of forest fires across central and southern Chile, leading to casualties and widespread damage. They followed earlier, destructive forest fires in December 2022 that spread rapidly around the city of Viña del Mar. With IFRC-DREF funding, the Chilean Red Cross provided support to more than 5,000 people. Staff and volunteer teams provided medical support and distributed cash so that people could buy the things they needed to recover.More information. 6. Deadly Marburg outbreak in Gabon In early February 2023, the Government of Equatorial Guinea reported the death of nine people who presented symptoms of hemorrhagic fever and soon after the WHO confirmed the country was experiencing an epidemic of Marburg disease. The Gabon Red Cross contributed to the government’s preventive measures and by 15 May, the epidemic over. Roughly CHF 140,000 in emergency DREF funds are now being used to increase the Gabon Red Cross’s ability to respond to Marburg disease and other outbreaks in the future by ensuring the mobilized personnel can detect suspected cases quickly, anticipate spread and prepare for a coordinated response with health authorities. 7. Severe hail storms in Armenia In June 2023, severe hailstorms struck various regions of Armenia, causing extensive damage and disruption. In the southern region, rural communities near the border experienced heavy precipitation that overwhelmed sewage systems, flooded streets and houses, and rendered roads and bridges impassable. The hail and subsequent flooding resulted in significant damage to houses, livestock, gardens, and food stocks. IFRC-DREF quickly allocated CHF 386,194to support Armenian Red Cross's efforts to help 2,390 people who lost crops, livelihoods or who suffered extreme damage to their homes. 8. Population Movement in Benin Around the world, there are hundreds of places where people are fleeing violence that rarely gets reported in international media. Here’s one case in point: over the past three years, non-state armed groups in the Sahel region has increased in the border area of Burkina Faso with Benin and Togo, forcing thousands to leave their homes. The IFRC-DREF allocated CHF 259,928 to support Benin Red Cross in assisting displaced people and host communities in Benin. The funds were used to provide immediate food and material aid to the most vulnerable households, covering immediate needs (shelter, access to drinking water, basic household supplies) for at least 3,000 people. 9. Cold spells and snowstorms in Mongolia A devastating snowstorm swept across eastern parts of Mongolia and certain provinces in Gobi areas, starting on 19 May 2023. The storm brought high winds and 124 people (mostly from herder community) were reported missing after following their livestock, which wandered off because of the storm. A total of 122 people were found, but tragically 2 people died. There were also severe damage to infrastructure, including the collapse of 22 electricity sub-stations, which caused power outage in several counties. Nearly 150 households suffered loss or severe damage to their “gers” or yurts (traditional circular, domed structures), as well as widespread death of livestock. IFRC-DREF allocated CHF 337,609 to support the Mongolian Red Cross's efforts to provide shelter, cash assistance and psychosocial support to 3,400 people. 10. Drought in Uruguay Uruguay is currently experiencing widespread drought due to a lack of rainfall since September 2022 and increasingly high temperatures in the summer seasons—prompting the Uruguayan government to declare a state of emergency. The government officially requested the support of the Uruguayan Red Cross to conduct a needs assessment of the drought, so it could understand how it was impacting people and agricultural industries. With funding IFRC-DREF, Uruguayan Red Cross teams headed out into the most-affected areas to speak to more than 1,300 familiesabout the drought’s impact on their health, livelihoods and access to water. Their findings are helping the government make more informed decisions on how to address the drought, taking into account the real needs of those affected.More information.

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| Press release

IFRC launches urgent CHF 3 million appeal to combat cholera outbreak in Zimbabwe

Harare/Nairobi/Geneva, 17 November 2023 —The International Federation of Red Cross and Red Crescent Societies (IFRC) has launched an emergency appeal for 3 million Swiss Francs to support the Zimbabwe Red Cross Society (ZRCS). The health needs exceed available resources, meaning immediate action to is needed to mitigate the impact on affected communities. Zimbabwe is currently grappling with a severe cholera outbreak, placing immense strain on healthcare systems, and necessitating coordinated action. The outbreak has led to increased morbidity and mortality rates, posing a significant threat to public health and demanding immediate attention. The IFRC had previously allocated CHF 464,595 from its Disaster Response Emergency Fund (DREF) to support the relief efforts. The Emergency Appeal focuses on critical areas, including the prevention and control of the cholera spread, improved case management, and the enhancement of water and sanitation facilities. The appeal also underscores the importance of community engagement, accountability, and inclusivity in providing a holistic response to the diverse needs of affected communities. John Roche, IFRC Head of Delegation Country Cluster for Zimbabwe, Zambia and Malawi said: “Access to clean and portable water remain among the most urgent needs in the community. We are deeply concerned with the situation unfolding as before the rains cases have escalated. The IFRC and Zimbabwe Red Cross Society are seeking resources through the appeal that supports activities that can contribute to stopping the spread and transmission of Cholera which will deescalate the worrying trends.” Zimbabwe Red Cross Society staff and volunteers have been mobilised and continue to respond to the outbreak by increasing awareness on water, sanitation, and hygiene (WASH) practices, emphasising the importance of WASH education for healthier communities. This commencement of public health education is being done in collaboration with Zimbabwe’s Ministry of Health. Currently the new cases reported are increasing at a high level and rising at an accelerating pace. This has created an urgency to increase mitigation measures to curb further spread and reduce cross border transmission. More information: For further details on our response to the Cholera outbreak in Zimbabwe, visit the Zimbabwe Red Cross Societywebsite or the IFRC appeal page. To request an interview, please contact: [email protected]     In Harare: Kim Stambuli,ZRCS:+263 71 251 72 64 In Nairobi: Rita Wanjiru Nyaga: +254 11 083 71 54 In Geneva: Tommaso Della Longa: +41 79 708 43 67 Mrinalini Santhanam: +41 76 381 50 06

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Risk reduction against water-borne diseases bears fruit in rural Kenya

In the last two years, villages like Cheplewa in the southewestern county of Bomet have witnessed a significant increase in diseases such as Cholera and Hepatitis B — two diseases triggered by consumption of contaminated water. To ensure comprehensive protection of water sources, the Kenya Red Cross and the IFRC have mobilized to educate communities on measures they can take to protect natural springs from contamination and then ensure that they remain clean. Springs serve as the main source of water in this region but it’s common practice for animals to be taken to the springs to drink. Meanwhile, residents also come to the spring and scoop the same water for domestic use. Chebett, a community health worker trained by the Kenya Red Cross, believes the lack of springs in neighboring villages accelerated the increase in Cholera cases. In the previous months, those villages also experienced an outbreak of Hepatitis B. A massive checkup ”At the time of screening and sensitizing communities about Covid-19, and about the importance of getting vaccinated, some people were diagnosed with Hepatitis B”, Chebett said. “We reported this to the Ministry of Health and they called for a massive checkup”. That checkup included community-wide screenings for Hepatitus B as well as continued sensitization on sanitation practices. Those found to be negative for Hepatitus B were vaccinated, while positive cases were given drug treatments. After several months, medical personnel from the Cheplewa dispensary embarked on another massive screening and vaccination, with the aim of eradicating the Hepatitis B virus in the area. But complete eradication became difficult because the Hepatitis B vaccine is given in two doses. Some community members took the first dose, but did not return. It was not long before symptoms — such as non-stop talking or speaking incoherently — began to appear. Mass screening is still ongoing to hasten the identification of new cases. The efforts come as part of IFRC’s focus on working with communities to build their resilience and support to break the cycle of disaster impacts amidst the changing climate. In the Horn of Africa, the alternating weather patterns have continued to cause drought and flooding, impacting water sources, livelihoods and food security. All these factors leave people more vulnerable to infectious diseases. Erasing fear by engaging communities Chebett said that when speaking with community members, she tells them that springs must be protected and the area kept clean. To avoid contamination of the water, communities were encouraged to build underground water tanks to collect spring water. Water taps were then installed next to these tanks at a distance of 10 meters. Community members were involved in the construction of the underground tanks. Though the spring water flowing through the taps is now clean, families were encouraged to boil the water used for drinking and cooking and store it in clean containers, and to keep the containers closed. Water pans for animals to drink were also created. Improved hygiene through education Because this area is between two hills, rainwater flowing down the hills also carries debris. Those who drink the water before boiling it could suffer from Acute Water Diarrhhoea. This led some families and community members to claim that the water had been poisoned and so they stopped drinking water altogether. But, after receiving information from community health workers who were trained by the Kenya Red Cross, they started boiling water used for drinking and cooking, and washing their hands before and after eating. The hygiene standards have also generally improved. Every household was encouraged to build a toilet, and to wash their hands after using the toilet. “The education we give is bearing fruit,” Chebett said of the community engagement efforts, which were made possible through support by USAID funded Community Epidemic and Pandemic Preparedness (CP3) programme.

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IFRC Secretary General Keynote speech at the 10th Pan African Conference in Nairobi

Excellencies, Ladies and gentlemen, distinguished guests, colleagues and friends, I’m so pleased to be here in vibrant Nairobi. You have always extended such warmth and enthusiasm every time I visit Africa. Thank you for your unmatched hospitality. I am grateful to Kenya Red Cross for hosting Pan African conference of the IFRC. IFRC Vice President Elder Bolaji Akpan Anani, Chair of the PAC. Governor Korir of the Kenya Red Cross. Governing Board members, Commission and Committee chairs of the IFRC, of the Standing Commission, Africa governance group, Vice President of ICRC (continuing our proud history to invite ICRC to IFRC statutory meetings because we can be successful when we work together as a Movement), National Society and youth leaders, staff and volunteers and the entire IFRC secretariat team. I want to particularly recognize the Africa team led by our Regional Director Mohammed Mukhier for working tirelessly to support the organization of the conference. I pay tribute to all of you for your immense contributions to the IFRC network, today and always. Your dedication to the communities we serve is unparalleled, especially through the recent growing complex crises across Africa. Let me join in solidarity with Morocco and Libya as they work hard to recover from two terrible disasters. As we gather here today, I am struck by the rich tapestry of Africa’s history, cultures, and the extraordinary resilience and spirit of its people. Yet, this comes with its own set of opportunities and challenges. A continent of immense beauty and diversity, Africa presents us with a complex humanitarian landscape. Africa is a place of paradoxes, where soaring aspirations uncomfortably co-exist with profound inequalities. Humanitarian needs are growing each day, stretching the bounds of lives, livelihoods, and human dignity. Poverty, inequality, and political instability compound these humanitarian needs. Economic challenges including high unemployment rates, limited industrialization, and a heavy reliance on primary commodities for export make many African nations vulnerable to fluctuations in global markets. We continue to witness alarming hunger levels across the continent, with 167 million facing acute food insecurity in Sub-Saharan Africa, a 14% increase from 2022. The impact of El Niño in 2023/2024, forecasts a 90% probability of flooding in Kenya, Somalia, and Ethiopia, alongside reduced rainfall in Southern Africa. We know this will further exacerbate food insecurity in the coming years, as African food systems are very vulnerable to climate extremes and shifts in weather patterns. Disease and epidemics are on the rise as a result. Last year, 96 disease outbreaks were officially reported in 36 countries, with cholera, measles, and yellow fever being the most common. As climate disasters worsen, 7.5 million people were displaced in Africa, the highest annual figure ever reported for the region. And with the cascading effects of political instability in a number of countries, the number of people on the move have begun to climb as well, with 9 million people torn from their homes in 2022. We cannot forget that behind these distressing statistics are actual people –women, men, and children with increasing needs and less resilience to cope. These are the challenges that exist in a continent which is full of young and dynamic population full of unparalleled vibrancy and dynamism. It also has many beautiful tourist destinations. This is a continent full of natural resources - minerals, oil and gas, timber, agricultural land, fisheries, renewable energy, gemstones, water resources, forestry products. Almost everything you can think of. It makes me wonder how come a continent so full of resources is also facing so many challenges. How can we contribute to addressing these humanitarian gaps? Please allow me to share just three fundamental approaches that could help us to make a meaningful contribution to the people and communities in Africa. First is Solidarity – Working together in partnerships: We are bound together in our journey in search of a brighter future. The expanding humanitarian needs push us to the brink, but our unwavering solidarity pulls us back and drives us forward. Solidarity and commitment to our Strategy 2030 and Agenda for Renewal allows us to respond to multiple crises and disasters, build community resilience and strengthen localization in this region. Just last month, I visited Gambia and Egypt to better understand the migration situation. My conversations with volunteers, National Society and government leaders were eye opening. When it comes to migration, Africa is a continent on the move. This comes with positive benefits too—In Gambia migrants contribute to 20% of the country’s GDP. To the rest of the world, the migration of Africans is often framed around their movement beyond Africa’s borders. Yet the story of the millions of refugees and internally displaced people being hosted within Africa, which is more than 85%, is not acknowledged. Through the IFRC’s Global Route-based Migration programme and humanitarian service points we witness how Africans are overwhelmingly supporting fellow Africans on the move. Africans standing shoulder-to-shoulder with fellow Africans, is a testament to our capacity to overcome adversity. As we address urgent crises before us, it's our combined strength that forms our bedrock of hope. Internal solidarity sometimes can be challenging. Let us not doubt ourselves in our commitment to solidarity. Let us foster trust and belief among ourselves. Second is Solutions to scale- think big, act big: Across Africa much progress has been made and the vast opportunities lie ahead. 34 countries, representing approximately 72% of Africa’s population, have demonstrated significant progress in governance over the last two decades, especially in the areas of rule of law, the protection of rights, and growth of civil society. Africa’s great untapped potential is more visible than ever, with economic growth and investment in public services contributing to the improvement of millions of lives and transformation of societies. The theme of this 10th Pan African Conference is renewing investment in Africa. I suggest that we make this investment people centric. You may want to consider calling it "renewing people-centric investment in Africa". I encourage every one of us to consider how investments in National Societies, and especially in their young volunteers, can harness Africa’s agility and innovation that empowers people to address the needs when they come and continue to work to reduce humanitarian needs by building long term resilience in the communities. For this, our Agenda for Renewal guides the IFRC to work for and with National Societies in everything we do. We have invested in scaling up digitalization, risk management, new funding models for greater agility, accountability, and impact to reach the communities. We foster learning and strengthen National Society capacities, so that we become leaders in the humanitarian field, not just in response but in resilience building, data, influence, collaboration, and innovation. In 2020-2021, during the COVID-19 pandemic, African National Societies came together with the IFRC secretariat to reach 450 million people with humanitarian services. The REACH initiative between Africa CDC, the African Union and the IFRC comes with an ambition to scale up the community health workforce by two million and strengthening National Society capacity across the continent to address health needs. These are solutions that are tailored to African communities, that reflect African needs and that can be measured by the outcomes we achieve for the people. Let’s not play small. Let’s think big, let’s act big. Because that’s what it is needed now. Third is Leadership – listen, learn and lead. Our humanitarian action must make a positive difference in people’s lives. In this era of fast paced change and shifting political divides, our leadership has never been more crucial. Leadership to partner with others along equal and mutually reinforcing terms, Leadership to position our National Societies as unparalleled community partner, with unmatched local intelligence and reach, Leadership to engage in internal transformation, Leadership to embody our Fundamental Principles, Leadership to invest in young people--Africa’s most abundant and greatest resource--harness their skills, give them opportunities to lead us to a more just and equitable future. Leadership to build trust, internally and externally, to be bold at communicating good news as well as challenges, to bring about collective energy and hope. Leadership that doesn’t accept business as usual. Leadership that strives for excellence in everything we do. There will be ups and downs, but we will persist. This is what leadership is all about. In our pursuit of a brighter future for Africa, let us hold ourselves to lead with accountability, not just to the challenges of today but also to the aspirations of tomorrow. Let every action we take, every initiative we launch, and every partnership we forge be a testament to our unwavering commitment to the people. I wish you a very productive Pan-African Conference. And please allow me to conclude by sharing a quote from Nelson Mandela – «one of the things I learned when I was negotiating that until I changed myself, I couldn’t change others». Let this conference give us the inspiration to be the real agent of change for the people of Africa. Thank you.

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Three months after the Kakhovka Dam disaster, Ukraine Red Cross still stands by affected communities

When the Kakhovka Dam in southern Ukraine collapsed in June, a torrent of water poured over downstream towns and farmlands, reducing homes to rubble and leading to the tragic loss of many lives. The flood swept up everything in its path, washing farm animals, unexploded mines, hazardous chemicals and dangerous bacteria—such as salmonella, E. coli, and cholera—down toward the Dnipro-Buh Delta on the Black Sea. The Ukraine Red Cross Society’s (URCS) response to the dam disaster was swift. From the moment the dam collapsed, their volunteers began evacuating people from flooded areas and distributing essentials such as food, hygiene products and water purification equipment. Psychosocial support specialists were also on hand to help people cope during those difficult first days. But recovering from a disaster like this doesn’t happen overnight. Three months on, URCS teams remain firmly by the side of communities to help them get their lives back on track. “People's needs have changed but have not disappeared," says Serhiy Moroz, a URCS volunteer. "In many populated areas, people are attempting to return to their previous lives in damaged housing and amidst disruptions in centralized water supply services. Often, water systems are simply non-existent, leaving people to suffer from a lack of clean water. This creates significant household challenges as well as risks to public health." The IFRC recently deployed an Emergency Response Unit or 'ERU'—a team of specialized personnel and equipment from across the IFRC network—to Kropyvnytskyi city to support the Ukraine Red Crescent Society’s work restoring access to safe water. Marco Skodak, the ERU team leader, details their efforts: "We're launching Water, Sanitation, and Hygiene (WASH) activities in response to the dam's destruction. URCS volunteers are undergoing training to provide assistance, and, working alongside our specialists, they are already on the ground conducting needs assessments and establishing crucial water purification systems and pipelines." By training up the Ukraine Red Cross Society in this way, the IFRC network is ensuring that communities get the long-term assistance they need to recover, and that volunteers have an even greater ability to respond should a similar disaster ever occur in future. -- Click here to learn about how the IFRC is supporting local humanitarian action, including the different types of ERUs we can deploy. And click here to learn more about the IFRC’s work in Water, Sanitation and Hygiene.

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The cholera emergency is avoidable

The world is facing an upsurge in cholera, even touching countries that have not had the disease in decades. Years of progress against this age-old disease have disappeared. While the situation is unprecedented, the lesson to draw is not a new one: safe drinking water, sanitation and hygiene are the only long-term and sustainable solutions to ending this cholera emergency and preventing future ones. The global cholera situation is concerning, but as we mark World Water Day today, and the historic United Nations Water Conference begins in New York, the Global Task Force for Cholera Control (GTFCC) is appealing to countries and the international community to channel that concern towards concrete action. First, to prevent future outbreaks, countries need strong 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 tackle the current crisis. We can’t solve a problem we can’t 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, responders rush in soap and chlorine tablets, bring in safe water in trucks, and build temporary latrines to prevent the outbreak from spreading. While these actions are undoubtedly life-saving, longer-term investments in WASH infrastructure can prevent outbreaks in the first place. Wherever in the world cholera has been eliminated, 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 issue, first and foremost, it is a development issue. Third, focus efforts on cholera hotspots. Fighting cholera requires a targeted approach centred on hotspots–health zones or districts–where cholera cases are concentrated. Focusing on cholera hotpots more than doubles the return on investments in safe water, sanitation and hygiene: from US$4.30 to US$10 for every US$1 invested. Fourth, support the development and implementation of national cholera plans, including the budget allocated for WASH. These national plans lay out multisectoral actions needed for sustained cholera prevention and control, including the use of oral cholera vaccines, putting communities at the center. Poverty, conflict, and disasters continue to fuel cholera, now turbo-charged by climate change. The future presents multiple challenges, but at least for cholera, we have the answer: access to safe water, sanitation and hygiene in cholera hotspots. Urgent, targeted investments will get us there. Note to editors In the past months, the world has seen a resurgence of cholera. Last year, as many as 30 countries experienced outbreaks, and we continue to see a 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 outbreaks which is concerning, but the severity with which they are striking. 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 with extreme climate events, which bring at times too much and at times too little water, both potent fuel for cholera as access to water supplies are disrupted, and people may be forced to move from their homes to more temporary—and at times crowded—settlements. Looking ahead, we can expect more frequent floods, droughts, storms and displacement. Other than climate change, modelling exercises show that population growth and urbanization alone could lead to a doubling of cholera cases over the next 20 years if we do not act now. For more information on the full multisector approach to cholera control and elimination, please 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 Global Cholera Control Champion Dr Frew Benson, Chair, GTFCC Steering Committee Dr Christopher J. Elias, President, Global Development, Bill & Melinda Gates Foundation Dr Howard Zucker, Deputy Director for Global Health, Centers for Disease Control and Prevention (CDC) Dr Seth Berkley, CEO, Gavi, the Vaccine Alliance Jagan Chapagain, Secretary General, International Federation of Red Cross and Red Crescent Societies (IFRC) Dr Christos Christou, International President, Médecins Sans Frontières Catherine Russell, Executive Director, UNICEF Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization Media Contacts Zambia National Public Health Institute Mazyanga Liwewe, [email protected] BMGF [email protected] CDC Erik M. Friedly, [email protected] Gavi, the Vaccine Alliance [email protected] IFRC Marie Claudet, [email protected] MSF Jean-Marc Jacobs, [email protected] UNICEF Sara Alhattab, +1 917 957 6536, [email protected] WHO [email protected]

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Cholera is back but the world is looking away

This article was originally published on the BMJ website here. Once thought to be close to eradication, cholera is back—dehydrating and killing people within hours and ravaging communities across six continents. Despite the alarming numbers of cases and deaths over the past year, decision makers are averting their eyes, leaving people to die from a preventable and treatable disease. The healthcare community should sound the alarm for immediate actions. A strong and global emergency response is urgently needed, but it is only a first step. More than ever the world must invest in water and sanitation systems and prepare communities before outbreaks occur. Over the past 200 years, there have been seven cholera pandemics, and today’s surge is the largest in a decade. In 2022, 30 countries reported cholera outbreaks, including places that had been free of the disease for decades. In Haiti, where millions of people have been displaced by violence, cholera has killed hundreds of people in just a few months.Lebanon is experiencing its first outbreak since 1993, with more than 6000 recorded cases.After devastating floods, Nigeria had a major cholera outbreak.In Malawi, the worst outbreak in decades has left 620 people dead since March.Schools are now closed in an attempt to stop the surge of infections. The risk of cholera transmission multiplies when people live in poor or overcrowded conditions and lack access to safe water, proper sanitation, and hygiene facilities. A diarrhoeal disease caused by theVibrio choleraebacteria, cholera is commonly spread through contaminated food or water. Left untreated, it can cause severe dehydration and be deadly within hours. Almost half of the world's population—approximately 3.6 billion people—live without safely managed sanitation in their home, leaving them vulnerable to cholera outbreaks. The World Health Organization reports that at least two billion people consume water from sources contaminated with faeces. Overlapping crises The root causes behind the spate of recent cholera outbreaks are, however, complex and multifaceted. Overlapping humanitarian crises around the world, such as migration, conflicts, poverty, and social injustice are forcing people to live in unsanitary conditions, and this is fuelling the spread of this infectious disease. In the aftermath of the covid-19 pandemic, the number of people living in extreme poverty increased for the first time in a generation. And now, rising inflation and the repercussions of the conflict in Ukraine could worsen an already dire situation. Climate change plays a part in contributing to the spread of cholera. More frequent and intense extreme weather events, such as hurricanes and floods, have resulted in major disruption to water treatment processes and damaged sanitary infrastructure in many parts of the world. The combination of higher temperatures and extreme precipitation leads to a higher incidence of waterborne infections like cholera. Factors such as food insecurity also exacerbate the vulnerability of communities to the spread of cholera. Malnourishment weakens the immune system, increasing a person’s risk of severe symptoms and death. As global events drive up food prices, the number of malnourished people has also risen. An estimated 140 million people in Africa face severe food insecurity. Cholera can be treated through a simple method called oral rehydration treatment, but many people cannot access this lifesaving tool—an estimated 56% of children with diarrhoea are not able to receive this treatment. Cholera can also be prevented through the oral cholera vaccine, but supply cannot meet current needs. By the end of 2022, 11 countries experiencing cholera outbreaks had requested 61 million doses of the vaccine—far more than the 36 million doses that were expected to be produced. The shortage of vaccines has recently forced the International Coordinating Group, of which the International Federation of Red Cross and Red Crescent Societies (IFRC) is a part, to switch from a two dose to a single dose strategy so that coverage can be expanded. Morally unacceptable In places such as Malawi and Haiti, the mortality rate from cholera tripled in 2022. Nobody should die from a preventable and treatable disease. This level of suffering is morally unacceptable. The IFRC has launched a time sensitive emergency response in 20 countries, where trained Red Cross and Red Crescent volunteers track transmission routes while also ensuring that sanitation facilities are working and that safe water supplies are available. At the community level, teams treat people by administering oral rehydration treatment and referring those most severely affected to hospital. In Malawi, where the number of infections is increasing daily, the Red Cross has established 14 oral rehydration points across the country and is reaching more than 753 000 people with health and hygiene campaigns. Volunteers also play a major part in cholera vaccination campaigns. The Lebanese Red Cross, for example, has contributed considerably to the rollout of the national cholera vaccination campaign. Through door-to-door visits of households, institutions, and organisations, the Lebanese Red Cross vaccinated more than 260 000 people in only 39 days across 151 municipalities. In countries where cholera is endemic, we are implementing sustainable long term water systems, sanitation, and hygiene programmes. For instance, in the countries where we are operating, we built and rehabilitated 1300 water systems, more than 7000 sanitation facilities in households, schools, and health centres, and close to 6000 handwashing stations, improving the lives of more than three million people around the world. Red Cross and Red Crescent staff and volunteers are on the frontlines of this public health emergency, but we are not able to do this alone. The resurgence of cholera around the world despite decades of eradication efforts suggest that cholera control, prevention, and response mechanisms must be rapidly amplified. To prevent outbreaks, reduce transmission, and save lives, we need political commitment and greater financial resources. We must ensure access to safe water supplies and invest in proper sanitation infrastructure in the communities most at risk. We need to increase the production and distribution of oral cholera vaccines. Public health systems and cholera treatment centres must be better funded. Lastly, we need to build trust in communities. People are less likely to follow preventive measures if they do not trust their community leaders and health systems. But to really put an end to cholera, we cannot forget the humanitarian crises at root level. Governments, non-governmental organisations, and the private sector must finally mobilise and increase investments in infrastructure and health and social systems so that they can withstand the fallout from disasters, conflicts, and climate change. One of the most important lessons we learnt from the covid-19 pandemic is that no one is safe until everyone is safe. It is in everyone’s best interests to work together and ensure that no one is left behind. -- Visit our water, sanitation and hygiene (WASH) page for more information about cholera. And follow Petra on Twitter for more updates on the IFRC's work in health and care: @petra_khoury

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| Press release

Malawi: Red Cross scales up response to worst cholera outbreak in two decades

Malawi, 25 January 2023—Malawi is currently facing its worst cholera outbreak in two decades, with over 29,000 cases reported and more than 900 people dead. The Malawi Red Cross, in partnership with the International Federation of Red Cross and Red Crescent Societies (IFRC) and in-country partners—Danish Red Cross-led consortium and Swiss Red Cross—is scaling up its cholera response to assist over two million people. Since the first recorded case in February 2022, cases have continued to spread, with all 29 districts affected. Cholera is now putting over 10 million people at risk, including more than five million children. “Malawi Red Cross Society is committed to continue supporting the Government of Malawi in responding to the cholera outbreak and other health emergencies. We are grateful to the IFRC and other Movement partners for continued finance and technical assistance to the MRCS Cholera response plan,” said McBain Kanongodza, Secretary General for the Malawi Red Cross Society. According to the Malawi Ministry of Health’s cholera update on 22 January 2023, over 29,364 cases and 960 fatalities were reported, leaving the fatality rate at 3.27 per cent, which is considerably higher than the acceptable rate of less than 1 per cent set by WHO. The Malawi Red Cross Society (MRCS) is already providing lifesaving treatment at the community level by administering Oral Rehydration Therapy. Volunteers ensure that water supplies are safe and that sanitation facilities are working. They also go door-to-door to raise awareness on preventing the disease from spreading. With the rainy season underway, it is crucial that people take precautions to protect themselves and their families. “We have been monitoring the developments on the ground since the first cases, and we are deeply concerned that this outbreak has taken a foothold in every corner of Malawi. We need to support the joint efforts of the MOH and Malawi Red Cross in their response to this devastating situation. As the outbreak worsens, partnerships are crucial to ensure lives are saved,” said John Roche, Head of IFRC’s Delegation for Malawi, Zambia and Zimbabwe. The IFRC and its membership are launching an Emergency Appeal seeking 5.2 million Swiss francs, which will help the Malawi Red Cross reach a further 1,385,391 people in need of assistance. Malawi Red Cross and its partners with the IFRC aim to target 15 affected districts, with the core objectives being to prevent and control the spread of the outbreak, reduce morbidity and mortality due to cholera and improve the availability of safe water and sanitation facilities, through continued support to communities and district health offices. For more information, please contact: In Lilongwe: Felix Washon, +265 999 95 57 21, [email protected] In Harare: Ella Mcsharry, +263 78 689 3350, [email protected] In Nairobi: Euloge Ishimwe, +254 731 688 613, [email protected] In Geneva: Marie Claudet, +1 202 999 8689, [email protected]

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| Basic page

Cholera

Cholera is a bacterial disease, usually spread through contaminated water, that causes severe diarrhoea and dehydration. It can kill, and thrives in poor or overcrowded conditions where access to safe water, sanitation and hygiene are compromised.

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| Press release

Shortage of cholera vaccines leads to temporary suspension of two-dose strategy, as cases rise worldwide

Geneva/New York, 19 October 2022 - A strained global supply of cholera vaccines has obliged the International Coordinating Group (ICG)—the body which manages emergency supplies of vaccines—to temporarily suspend the standard two-dose vaccination regimen in cholera outbreak response campaigns, using instead a single-dose approach. The pivot in strategy will allow for the doses to be used in more countries, at a time of unprecedented rise in cholera outbreaks worldwide. Since January this year, 29 countries have reported cholera cases, including Haiti, Malawi and Syria which are facing large outbreaks. In comparison, in the previous 5 years, fewer than 20 countries on average reported outbreaks. The global trend is moving towards more numerous, more widespread and more severe outbreaks, due to floods, droughts, conflict, population movements and other factors that limit access to clean water and raise the risk of cholera outbreaks. The one-dose strategy has proven to be effective to respond to outbreaks, even though evidence on the exact duration of protection is limited, and protection appears to be much lower in children. With a two-dose regimen, when the second dose is administrated within 6 months of the first, immunity against infection lasts for 3 years. The benefit of supplying one dose still outweighs no doses: although the temporary interruption of the two-dose strategy will lead to a reduction and shortening of immunity, this decision will allow more people to be vaccinated and provide them protection in the near term, should the global cholera situation continue deteriorating. The current supply of cholera vaccines is extremely limited. Its use for emergency response is coordinated by the ICG which manages the global stockpile of oral cholera vaccines. Of the total 36 million doses forecast to be produced in 2022, 24 million have already been shipped for preventive (17%) and reactive (83%) campaigns and an additional 8 million doses were approved by the ICG for the second round for emergency vaccination in 4 countries, illustrating the dire shortage of the vaccine. As vaccine manufactures are producing at their maximum current capacity, there is no short-term solution to increase production. The temporary suspension of the two-dose strategy will allow the remaining doses to be redirected for any needs for the rest of the year. This is a short-term solution but to ease the problem in the longer term, urgent action is needed to increase global vaccine production. The ICG will continue to monitor the global epidemiological trends as well as the status of the cholera vaccine stockpile, and will review this decision regularly. About the ICG The ICG is an international group that manages and coordinates the provision of emergency vaccine supplies and antibiotics to countries during major disease outbreaks. It manages the global stockpile of the oral cholera vaccine. The group is composed of members of WHO, Médecins Sans Frontières, UNICEF and the International Federation of Red Cross and Red Crescent Societies. The ICG was established in 1997, following major outbreaks of meningitis in Africa, as a mechanism to manage and coordinate the provision of emergency vaccine supplies and antibiotics to countries during major outbreaks. Since the establishment of the cholera vaccine stockpile in 2013, 120 million doses of oral cholera vaccine doses have been shipped to 23 countries, of which 73 million (60%) has been approved for emergency response. Media contacts IFRC: Jenelle Eli +41 79 935 97 40 +1 202 603 6803 [email protected] MSF: Lukas Nef  +41792400790 +41443859457 [email protected] UNICEF: Tess Ingram +1 347 593 2593 [email protected] WHO: WHO Media inquiries Telephone: +41 22 791 2222 Email: [email protected]

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| Emergency

Haiti: Earthquake and Cholera

A major 7.2-magnitude earthquake hit Haiti on 14 August 2021, killing more than 2,000 people and causing widespread destruction to people's homes and infrastructure. The Haiti Red Cross Society responded rapidly to provide immediate humanitarian assistance to those affected. More than one year on, this Emergency Appeal is supporting ongoing recovery and reconstruction efforts. And in December 2022, we revised the Appeal to also help the Haiti Red Cross Society control a Cholera outbreak in the country through water, sanitation and hygiene (WASH) and community engagement activities.

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| Press release

Mozambique Cyclone: Signs of recovery, but long road still ahead

Beira/Nairobi/Geneva, 14 April 2019 – One month after the worst disaster in Mozambique’s recent history, signs of recovery are beginning to emerge as people return home and as the deadly cholera outbreak appears to be starting to abate. However, hundreds of thousands of people will need sustained support over the coming months if recovery is to take hold, says the International Federation of Red Cross and Red Crescent Societies (IFRC). Florent Del Pinto, Head of Emergency Operations for IFRC in Beira, said: “There is still a huge amount of work to do, but some of the immediate dangers are passing. “New cholera cases are declining. This is thanks in part to the work of Red Cross volunteers and staff who have provided clean water and sanitation, as well as treatment and care. But we cannot afford to be complacent – this work has to continue.” The disaster response operation, led by the Mozambique Red Cross with support from IFRC and other partners, has helped more than 38,000 survivors in the month since Cyclone Idai made landfall. Relief supplies have been distributed to some 19,000 people, 900 people have been treated at Red Cross field hospitals and clinics, and more than 250,000 litres of clean water have been produced and distributed. “This work has been effective, and we are now starting to see the initial green shoots of recovery in central Mozambique,” said Titus Queiroz dos Santos, Mozambique Red Cross Director of Programmes. “The survivors of this disaster are still suffering, but many are already determined to go home and rebuild their lives and livelihoods. The Red Cross will be there to support them at every step of the journey.” The Mozambique government has reported that the number of people still sheltering in relocation centres has dropped by half in recent days. The Mozambique Red Cross and partners are distributing relief supplies such as tarpaulins and shelter kits to people in need, and IFRC is deploying a dedicated team to plan a 24-month recovery programme focused on shelter, health, livelihoods and disaster risk reduction. Some 1.85 million people were affected by Cyclone Idai, which the World Bank estimates has caused 2 billion US dollars of damage in the affected countries. The Mozambique Red Cross and IFRC Emergency Appeal seeks 31 million Swiss francs to support 200,000 people.

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