Cholera is a high threat pathogen that is endemic in some parts of the WHO South-East Asia Region. The Region has witnessed small and large outbreaks in the past, especially in high-risk settings. A large outbreak in 2017 in the Rohingya refugee camps of Cox’s Bazar, Bangladesh followed by recent outbreaks, including those in peri-urban slums of Chandigarh (India); Panchkula, Haryana (India); continued incidence of cholera in Rohingya refugee camps, Cox’s Bazar (Bangladesh); and Krishnanagar Municipality of the Kapilvastu district (Nepal) draw attention to the continued vulnerability of the WHO’s SEA region to the threat of cholera.
The Infectious Hazard Management (IHM) Unit of WHO SEA Region is the regional focal point for implementing “Ending cholera - the global road map to 2030.” It includes and is not limited to monitoring the cholera situation in the region and facilitation of annual reporting of the regional cholera situation for the global cholera report.
The IHM Unit provides technical support for risk mitigation, preparedness and response to cholera related public health emergencies. As part of this mandate, IHM/WHE/SEARO is facilitating the roll-out of the Country Support Platform (CSP) in Bangladesh coordinated by the Global Task Force on Cholera Control (GTFCC).
The GTFCC is a partnership of more than 50 institutions with a secretariat hosted by the Global Cholera Programme of the WHO. The CSP is an integral part of the GTFCC and by virtue of serving as its operational arm will provide countries with multisectoral operational and technical support as well as advocacy, coordination and policy guidance. The CSP will help countries to develop, fund, implement and monitor their national cholera plans more effectively.
Among the handful of countries targeted by the GTFCC, Bangladesh has been identified as the Asian country that will benefit most from the CSP support. The IHM Unit has already provided technical support for the monitoring and controlling of a large outbreak of cholera in Lumbini province (at least 1211 cases of acute diarrhoeal disease and 6 deaths) that was spread across five districts of Krishnanagar, Maharajgunj, Shivaraj, Bijaynagar, and Yasodhara. The outbreak was confirmed as having caused by Vibrio cholera O1 Ogawa. The outbreak investigation and risk assessment were carried out by the Epidemiology and Disease Control Division (EDCD), Ministry of Health and Population (Nepal) along with the Provincial and District teams in collaboration with WHO and External Development Agencies at the field level.
The IHM Unit along with the GTFCC Secretariat and the WHO Country Office for India, monitored the outbreak and control measures as there was a threat of cross-border spread from Nepal to India . As part of the outbreak response and in response to the request from EDCD, the IHM Unit coordinated with GTFCC the mobilization of the support of the International coordinating group (ICG ) for Oral Cholera Vaccine (OCV). The OCV campaign targeted a total target population of approximately 252 000 in the five affected districts in Nepal and was instrumental in containing the further spread of the outbreak.
In the coming months the IHM unit of WHO SEA Region will facilitate the development/updating and implementation of National Cholera Plans (NCPs) in other cholera-affected countries with technical support from the GTFCC.