Global leaders call for commitment to end the global cholera emergency

June 3, 2024

News

Although vaccine supplies are expected to increase, cholera outbreaks continue to strain health systems

On Wednesday, 29 May 2024, seven countries and 10 major health partners affiliated with the Global Task Force on Cholera Control (GTFCC) came together in a powerful show of multisectoral commitment to end the global cholera emergency. The convening – a side event in observance of the 77th World Health Assembly (WHA) – took place as cholera continues to ravage communities across the world, with vaccine supplies unable to meet escalating needs.

The International Federation of Red Cross and Red Crescent Societies (IFRC), the United Nations Children’s Fund (UNICEF), and the World Health Organization (WHO) – in partnership with the GTFCC – co-hosted the side event, urging immediate collective action with only six years left to meet the GTFCC’s 2030 global roadmap goals. Titled Uniting Against the Global Cholera Emergency: Empowering Communities, Facilitating Multisectoral Actions, and Galvanizing Resources, the event took place at IFRC’s office in Geneva, Switzerland and gathered representatives from national governments, international non-governmental organizations, donor and partner organizations, and UN agencies.

Global health leaders focused on the critical need for sustainable funding to advance safe water, sanitation and hygiene (WASH) services, strengthen disease surveillance in cholera hotspots and scale up local oral cholera vaccine manufacturing. Case management and continuous community engagement for infection prevention were also discussed.

Health ministers and national representatives from Bangladesh, Lebanon, Malawi, Mozambique, Nepal, Zimbabwe, speaking on behalf of cholera-affected countries, underscored the urgency of a coordinated multisectoral approach, particularly given the compounding impacts of climate-related factors, economic insecurity, conflict, urbanization, population growth and population displacement.

Cholera, a severe diarrheal disease, that also affects children, has been a persistent global health challenge, specifically affecting communities with limited access to clean water and sanitation. In recent years, the world has witnessed an acute resurgence of the long-standing cholera pandemic, with 23 countries currently reporting outbreaks, along with deaths numbering in the thousands.

In his opening remarks as co-host, IFRC Secretary General, Mr Jagan Chapagain, said: “We cannot accept such a staggering loss of life to a disease that is entirely preventable and treatable with the tools we have in the 21st century. This event serves as a stark reminder that there is much more work to do as we approach 2030. We must urgently refocus our efforts and elevate cholera control to the forefront of global dialogues, while backing it with tangible investments at the grassroot level.”

The cholera upsurge has placed pressure on health systems, and the demand for vaccines has far exceeded available supplies, which prompted agencies to instate emergency measures to manage the available stockpile in 2022. Mr. Thabani Maphosa, Managing Director of Country Programmes Delivery at Gavi, the Vaccine Alliance, emphasized, “We have significantly increased vaccine supplies over the past decade, and the stockpile is currently replenished after depleting at the start of 2024 after responding to cholera emergencies. With the new simplified Oral Cholera Vaccine, we are on track to reach 50 million doses in 2024, a 30% increase from 2023. He added, in reference to Gavi’s efforts to raise funds for its work from 2026 to 2030, including financing the global OCV stockpile, preventive and emergency vaccination, and cholera diagnostics: “The replenishment is for all of us, and I invite you to be ambassadors for that.”

WHO Deputy Director General and Executive Director of the WHO Health Emergencies Programme, Dr Michael Ryan, called cholera “a diabolic poster child of climate change, of poverty, and of social injustice at every level.” Dr Ryan also reminded attendees that cholera is “a pandemic that has never ended,” noting that the ultimate solution to ending the disease lies in universal access to safe water and sanitation. “The cholera vaccine is a poor substitute for a clean glass of water,” he said.

UNICEF Deputy Executive Director, Mr Ted Chaiban highlighted the importance of community engagement in ensuring a cholera-free future, calling for “additional resources and immediate actions to ensure access to safe WASH for all communities,” given that “2 billion people still lack access to safely managed drinking water and 3.6 billion people lack access to safely managed sanitation.”

Ms. Christine Toudic, Deputy Permanent Representative of the Permanent Mission of France to the United Nations Office at Geneva and other international organizations in Switzerland, called for further mobilization of partners to confront cholera, a disease primarily affecting communities in countries with the most fragile health systems. Ms. Toudic announced that the French government’s commitment will be reaffirmed in Paris on June 20, 2024, at a high-level event convened jointly with the African Union, Gavi, and Team Europe partners for the launch of the African Vaccine Manufacturing Accelerator (AVMA) and the 2026-2030 Gavi replenishment.

As the world confronts the ongoing challenges of seemingly never-ending cholera outbreaks, coordinated global efforts and sustained investments are critical. The GTFCC and its partners remain dedicated to empowering communities, facilitating multisectoral actions, and galvanizing resources to end cholera, all of which was confirmed during the side event. This reality was underscored by the involvement of the Africa Centres for Disease Control and Prevention (Africa CDC), the US Centers for Disease Control and Prevention (US CDC), Médecins Sans Frontières (MSF), the Swiss Agency for Development and Cooperation (SDC), Wellcome, the Bill and Melinda Gates Foundation and Gavi, the Vaccine Alliance in the event.

The message was – and remains – clear: achieving global health equity, security and resilience requires the defeat of cholera.

Notes to editors

About Cholera Outbreaks

In 2022, 44 countries reported cholera cases, a 25% increase from the 35 countries that reported cases in 2021. While the full data for 2023 will be published by WHO later this year, preliminary trends indicate that the situation continues to be concerning. Since the beginning of 2023, a total of total of 824 479 cholera cases and 5900 deaths were reported. This is a stark underrepresentation of the actual cholera burden, as detection and reporting capacities are hampered by inadequate access to conflict-affected areas, limited surveillance capacities, stigma, etc. A particular area of concern is the high Case Fatality Rate (CFR), which currently exceeds the 1% threshold in several areas. Seven nations – including Comoros, DRC, Ethiopia, Haiti, Somalia, Yemen, and Zimbabwe – are currently facing acute crises. Outbreaks are also emerging in regions that have not experienced cholera in decades, such as Syria, Lebanon, South Africa, Eswatini, and the French department of Mayotte. The urgency required to address and contain these outbreaks cannot be overstated, with 1 billion people are at risk for cholera infection.

Speakers and Representatives

Prominent speakers included Hon. Dr Firass Abiad, Minister of Health from Lebanon, Hon. Dr Douglas Mombeshora, Minister of Health and Child Care from Zimbabwe, Hon. Pradeep Yadav, Minister of Health and Population from Nepal, Mr. Md Mamunur Rashid, Joint Secretary with the Bangladesh’s Ministry of Health and Family Welfare, Dr Nitta Nayeja, Deputy Head of Clinical Services from Malawi’s Ministry of Health, Dr Sofia Viegas, Deputy General Director from Mozambique’s National Institute of Health (INS), and Ms Christine Toudic, Deputy Permanent Representatives from the Permanent Mission of France to the UN.

Other high-level speakers included Mr. Jagan Chapagain, IFRC Secretary General, Dr. Michael Ryan, WHO Deputy Director General and Executive Director of the WHO Health Emergencies Programme, Mr. Ted Chaiban, UNICEF Deputy Executive Director, H.E. Dr Jean Kaseya, Director-General from the Africa CDC, Dr. Kayla Laserson, Director of the Global Health Center from the US CDC, Dr Maria Guevara, International Medical Secretary from MSF, Mr Stuart Vallis, Health and WASH Representative from SDC, Dr. John-Arne Røttingen, Chief Executive Officer from Wellcome, Ms Rachel Toku-Appiah, Director of Program Advocacy and Communications (Africa) from the Bill and Melinda Gates Foundation, and Mr Thabani Maphosa, Managing Director of Country Programmes Delivery from Gavi, the Vaccine Alliance.

For more information, please contact:

GTFCC Secretariat focal point: Marion Martinez Valiente, WHO Technical Officer, gtfccsecretariat@who.int

GTFCC Country Support Platform: Jayanthi Palani, IFRC CSP Resource Mobilization & Advocacy Senior Officer, countrysupportplatform@ifrc.org