Slipping Away? A Review of Humanitarian Capabilities in Cholera Response

Over the past two years there has been a notable uptick in cholera outbreaks and deaths. The greater number of countries experiencing cases, combined with an unusual geographical distribution of outbreaks and unacceptably high case fatality rates, has raised concerns about the global capacity for cholera response аnd control, and whether some past progress has been lost.

A deadly but relatively easy disease to treat if caught in time—and one that often occurs within the context of a broader emergency—cholera has long been considered a basic staple of core humanitarian business. It was a disastrous performance in response to a cholera outbreak among Rwandan refugees in Goma in 1994 that shook and subsequently reshaped the modern humanitarian system, establishing standards, operational guidance, and coordination structures meant to better enable rapid and effective life-saving response. Three decades later, what is going wrong?

While cholera outbreaks can have multiple contributing factors—including armed conflict, development and governance failures, and the effects of climate change—these lie largely outside the influence of humanitarian actors. While not discounting the broader issues, such as lack of investment in water and sanitation infrastructure and other more sustainable solutions, this rapid review focuses on the response element—the humanitarian capacities, competencies, and coordination.