Global health understands that cholera is a critical, urgent issue. Global, national and local collegiality are ready and committed to tackle the issue. Ongoing work should be championed without delay.
Global health provides streamlined navigation for cholera control. The World Health Organization (WHO) highlights emergency kits, outbreak management and vaccination in materials [1]. WHO also refers to a unified global task force, and this clearly communicated navigation is greatly appreciated.
The Global Health Task Force on Cholera Control (GHTFCC) has a strong leadership steering course [2]. The 2030 roadmap is specific, particularly the cost presentation, burden and indicators on progress.
The roadmap was published in 2017 and it’s unclear if the 2017, 2018 and 2019 timeline action items were actually accomplished. It’s also unclear if the 2020 outcome indicators (Appendix C) were met for 2020 [3].
Financing the water, sanitation, and hygiene (WASH) initiatives is complex. The Roadmap points to a 2019 stakeholder meeting on cholera control WASH funding. The decisions and outcomes from the meeting are unknown, including what’s left unfunded, how funding is tracked, how programs are audited, how those not eligible for GAVI programs are included, how much of the burden is not covered by other programs and how corruption is avoided. Despite formal handoff to WaterAid, these items do not appear to be publicly available and may not have been assessed [4].
How WHO works with cholera kits and cholera vaccine assistance could be clearer. Where WHO work can better merge, if applicable, could also be clearer.
The Country Support Platform for cholera management may or may not align with other epidemiological programs with standardized templates for individual country data. How these templates are streamlined, as well as how global health and global policy organizations access the most accurate data, is unknown.
Inclusion of labor, education and training of professional epidemiologists is an opportunity for action plans, and for formal outcome measures.
The United States continues to support cholera control worldwide through public and private aid, research and medical labor overseas.
It is not clear how medical missions work are aligned with national and global health plans for cholera control. It is not clear if they use the same materials, contribute to the data or even if funding and volunteer labor is factored into global reports. Financial and quality of practice audits are also absent in medical missions work, and absent for cholera contributions [5,6].
How the CDC aligns with the GHTFCC is not clear, nor is GHTFCC referenced at the CDC [7].
There is a major gap around national association, Department of State/USAID efforts and other infrastructure WASH support. How construction, facilities, sewage and sanitation expertise are built is not clear. Any labor and staffing assessments that may have been conducted, or if alignment of the assessments alongside GHTFCC, is not described.
Research priorities for cholera are clear for a national department yet unclear in an international strategic research gameplan. NIH and partners may be potentially maligned. Therapeutics focus could be an international gameplan, particularly with intellectual property and financing considerations down the line [8,9].
Direct cholera aid and healthcare provided by federal agencies and national organizations could be clearer, including aid provided through military assistance.
Cholera work is dedicated and strong. Global health should adopt a less tolerant approach to ongoing cholera disease, everywhere. It’s quite unacceptable to continue at a slow pace of change.
References
https://www.gtfcc.org/news/zoom-on-wateraid-chair-of-the-gtfcc-wash-working-group/
https://www.pqmd.org/emergency-aid-yemen-cholera-food-insecurity/
https://umcmission.org/september-2022/stopping-the-spread-of-cholera-in-north-katanga/
https://www.niaid.nih.gov/diseases-conditions/cholera-treatment-and-prevention
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