Have a look at the latest One WASH brochure

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One WASH promotes a common yet adaptable approach among National Red Cross Red Crescent Societies to establish large-scale, long-term sustainable water and sanitation programmes and to broaden its scope to prioritize its impact in cholera elimination, nutrition, provision of water for livestock, strengthening delivery of improved hygiene and in both rural and urban settings. This new, broadened initiative reflects our approach in integrating WASH and Health in a more sustainable solution to the holistic needs of vulnerable populations.
Every case and death from cholera is preventable with the tools we have today: effective cholera prevention and control interventions are well established. However, current efforts focus more on emergency response that have a minor impact on long-term control or elimination of cholera over time.

Implementing One WASH

One WASH focuses on 18 cholera-affected countries initially where National Red Cross and Red Crescent Societies are committed to the elimination of the disease. The strategy focuses on two main actions that are closely interlinked and operate in full alignment with the GTFCC cholera road map, the Global Water and Sanitation Initiative, and IFRC cholera strategy.

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1. Improve preparedness, early detection, and response to contain cholera outbreaks

The One WASH programme will support communities to be well prepared for early response when an outbreak happens. It will support existing health care systems with community-based surveillance for early detection and monitoring of diarrhoeal outbreaks at community level. It will also improve access to care by providing community level treatment through provision of oral rehydration therapy, setting up Oral Rehydration Points and referrals of severe cases. Prevention activities such as water treatment, hygiene and health promotion are included as key parts of the approach to managing outbreaks. In addition, the approach will support local governments and partners with oral vaccination campaigns in emergency situations as appropriate.

2. A long-term integrated WASH approach to prevent cholera

One WASH will invest in sustainable long-term water, sanitation and hygiene programmes, and will embed health and nutrition support as well as provision of water for livestock in integrated WASH programmes as appropriate. Year-round health and hygiene behaviour change communication and social marketing programmes will be implemented in communities, including advocacy and support to cholera vaccination campaigns.

For more information please download the leaflet or contact Robert Fraser or Alexandra Machado

IFRC presentation GTFCC Annecy June 2018
OneWASH June18 ppt

Islamic Innovative Funding Model IFRC_Sukuk_Wash_06_big_pdf

IFRC Cholera framework Africa

Africa IFRC & WHO together to eliminate Cholera

IFRC OFID proposal One WASH OFID Revised proposal (2) May 18

The Global Task Force on Cholera Control (GTFCC)brings together all multi-sector technical partners from around the world to support countries in their fight against cholera, offering an effective and well-coordinated platform whose secretariat is hosted by the World Health Organization (WHO). Launching the strategy titled Ending Cholera: A Global Roadmap to 2030, the GTFCC partners aim to reduce global cholera deaths by 90%. With the commitment of cholera-affected countries, technical partners, and donors, as many as 20 countries could eliminate disease transmission by 2030.

for more information regarding Global Task Force on Cholera Control

Global Task Force on Cholera Control Website
declaration-ending-cholera (1)

Important Resources and links

Click here to link to page on cholera and related resources

Cholera in Africa please visit “The West & Central Cholera platform”(it will be extend to Eastern and Southern Africa soon) Cholera platform

Stop Cholera , John Hopkins is a collection of practical resources

STOP cholera toolkit
Training packages WHO and WASH cluster Cholera Repository
UNICEF cholera toolkit Cholera-Toolkit-2017


Sanitation Updates

A Bibliography of WASH and Cholera Studies

A Bibliography of WASH and Cholera Studies, September 17, 2019
In response to an information request, we have compiled a bibliography of 29 studies and reports published in 2018 and 2019 that discuss WASH-related aspects of cholera epidemiology and prevention/control. Please add additional studies to this google document or contact us to add additional resources such as videos, webinars, etc.

Global Cholera Epidemiology: Opportunities to Reduce the Burden of Cholera by 2030.

The roadmap consists of targeted multi-sectoral interventions, supported by a coordination mechanism, along 3 axes: (1) early detection and quick response to contain outbreaks; (2) a multisectoral approach to prevent cholera recurrence in hotspots; (3) an effective partnership mechanism of coordination for technical support, countries capacity building, research and M&E, advocacy and resource mobilization.

Broad approaches to cholera control in Asia: Water, sanitation and handwashing. Vaccine, August 2019.  

Increased research to develop and policy flexibility to implement a new generation of solutions that are designed specifically to address the physical, financial and political constraints of low-income communities offers the best prospect for reducing the burden of cholera across Asia.
Cholera Treatment Centers/Healthcare Facilities
Formative research for the design of a scalable water, sanitation, and hygiene mobile health program: CHoBI7 mobile health program.
BMC Public Health, 2019. This study presents a theory- and evidence-based approach that can be implemented for the development of future water, sanitation, and hygiene mHealth programs in low-resource settings.

Technical Note: Water, Sanitation and Hygiene and Infection Prevention and Control in Cholera Treatment Structures.

Global Task Force on Cholera Control, January 2019. Cholera treatment facilities provide inpatient care for cholera patients during outbreaks. Proper case management and isolation of cholera patients is essential to prevent deaths and help control the spread of the disease.

Assessment of Recommendation for the Containment and Disinfection of Human Excreta in Cholera Treatment Centers. Water, January 2019.

 These findings suggest that the use of 30% hydrated lime suspensions or 2% chlorine solutions may offer a simple public health protection measure for the containment, safe handling, and disinfection of human excreta during humanitarian emergencies. Epidemiological aspects Epidemiology of cholera. Vaccine, August 2019. There are many similarities in the spread, dynamics and risk factors for cholera in areas around the world where the disease occurs, but there are also important differences.

Recurrent Cholera Outbreaks, Democratic Republic of the Congo, 2008–2017. EID, May 2019. 

The 2017 nationwide outbreak resulted from 3 distinct mechanisms: considerable increases in the number of cases in cholera-endemic areas, so-called hot spots, around the Great Lakes in eastern DRC; recurrent outbreaks progressing downstream along the Congo River; and spread along Congo River branches to areas that had been cholera-free for more than a decade.

Individual and household exposures associated with cholera transmission in case–control studies: a systematic review. Trop Med Intl Health, July 2019. 

Despite strong evidence for cholera transmission via foodborne?, hygiene?, waterborne? and close personal contact?related pathways in both domestic and public domains, we found that non?waterborne?related factors are understudied. Future cholera case–control studies would benefit from investigating all transmission vehicles and transmission domains.

Risk factors associated with the recent cholera outbreak in Yemen: a case-control study. Epidemiol Health, April 2019. 

In order to reduce the risk of cholera, hygiene practices for washing khat and vegetables and the use and accessibility of safe drinking water should be promoted at the community level.

Micro-Hotspots of Risk in Urban Cholera Epidemics. Journal of Infectious Diseases, October 2018. Using data from urban epidemics in Chad and Democratic Republic of the Congo, we estimate the extent of spatiotemporal zones of increased cholera risk around cases. In both cities, we found zones of increased risk of at least 200 meters during the 5 days immediately after case presentation to a clinic.

Environmental reservoirs of Vibrio cholerae. Vaccine, July 2019.

 This article focuses on the epidemiological importance of the environmental reservoir of V. cholerae, considering several investigations made on different types of aquatic fauna (zooplanktons, crustaceans, etc.) and flora (macrophytes and microphytes).

Cholera surveillance and estimation of burden of cholera. Vaccine, July 2019.

There is also growing evidence suggesting that climate change and urbanization are likely to play an increasing role in the global persistence of cholera.

Household Water Treatment/Sanitation

Household Water Treatment and Cholera Control. J Infect Dis. November 2018. We conducted a systematic review of published and gray literature to determine the outcomes and impacts of HWT in preventing cholera specifically.

Quick impact projects have a long-term effect on cholera in Yemen. UNICEF, August 2019.

UNICEF and its partners rehabilitate sanitation networks in cholera high-risk districts of Aden and Sana’a.

Drinking water quality and human dimensions of cholera patients to inform evidence-based prevention investment in Karonga District, Malawi.

Water Supply, June 2019. Our aim was to investigate drinking water source quality compared with water treatment, risk perception and cholera knowledge for patients who had reported to a health center for treatment.

A Systematic Review and Meta-Analysis of the Association between Water, Sanitation, and Hygiene Exposures and Cholera in Case–Control Studies. Am J Trop Med Hyg, August 2018.

To our knowledge, the evidence on the association between WASH exposures and cholera transmission has not been summarized from case–control studies. To fill this evidence gap, we performed a systematic review of cholera case–control studies to summarize the association between WASH exposures and cholera transmission.

Humanitarian situations

Cholera prevention and control in refugee settings: Successes and continued challenges. PLoS NTDs, June 2019. The success of cholera prevention and control in refugee camps over the past 2 decades highlights the possibility of managing this deadly disease, even in complicated humanitarian crises. Sphere standards and associated control strategies have been shown to be effective in humanitarian crisis settings, dramatically reducing the number and size of outbreaks seen in refugee camps.

Evaluation of an Emergency Bulk Chlorination Project Targeting Drinking Water Vendors in Cholera-Affected Wards of Dar es Salaam and Morogoro, Tanzania. American Society of Tropical Medicine and Hygiene, June 2019. Bulk chlorination offers an efficient method to provide treated water to populations at risk of cholera, without having to rely on household water treatment options, which require additional resources to ensure water treatment behavior change.

Responding to epidemics in large-scale humanitarian crises: a case study of the cholera response in Yemen, 2016–2018. BMJ Global Health, June 2019. Our case study starkly highlights the importance of disease risk assessment, preparedness planning and coherent early strategies for cholera control in conflict-affected states.

Prevention and Control

Neutralization of cholera toxin by Rosaceae family plant extracts. BMC Complementary and Alternative Medicine, June 2019. The traditional application of the Rosaceae plant infusions for diarrhea appears relevant to cholera, slowing the growth of pathogenic bacteria.

Feasibility of a Comprehensive Targeted Cholera (CTI) Intervention in The Kathmandu Valley, Nepal.

American Society of Tropical Medicine and Hygiene, May 2019. The initial pilot of the CTI program in the Kathmandu Valley suggests that this type of cholera-control approach is feasible in an urban, developing country setting.

Global oral cholera vaccine use, 2013–2018. Vaccine, September 2019.

In 2013–2018, a total of 83,509,941 OCV doses have been requested by 24 countries, of which 55,409,160 were approved and 36,066,010 eventually shipped in 83 deployments, resulting in 104 vaccination campaigns in 22 countries.

Cholera control and prevention: Role of evidence-based advocacy and communications. Vaccine, June 2019. 

The article discusses strategic communications and advocacy programs for cholera that can be instrumental in paving the way for cholera vaccine use.

Exploring the development of a household cholera-focused health literacy scale in James Town, Accra.

Journal of Infection and Public Health, January–February 2019. This study attempted to develop a tool to measure cholera-focused health literacy among the urban poor.

Estimating cholera incidence with cross-sectional serology.

Science Translational Medicine, February 2019. Simulated serosurveys showed that this simple antibody-based approach could potentially be used as an alternative method to estimate cholera incidence in a population.

Non-vaccine strategies for cholera prevention and control: India’s preparedness for the global roadmap. Vaccine, August 2019.

A National Taskforce for Cholera Control must develop India-specific ‘National Cholera Prevention and Response Road Map’ with an appropriate administrative and financially viable framework for its implementation.

The case-area targeted rapid response strategy to control cholera in Haiti: a four-year implementation study. PLoS NTDs, April 2019. 

Rapid implementation of education sessions, household decontamination, soap distribution and water chlorination in affected communities proved challenging but possible, even in a mountainous and decentralized country such as Haiti.


Modeling cholera dynamics at multiple scales: environmental evolution, between-host transmission, and within-host interaction

Mathematical Biosciences and Engineering, January 2019. We have presented a new cholera modeling framework that involves three distinct time scales: the slow scale for the environmental bacterial dynamics, the intermediate scale for the between-host disease transmission, and the fast scale for the within-host pathogen interaction.

Food insecurity and self-reported cholera in Haitian households: An analysis of the 2012 Demographic and Health Survey. PLoS NTDs, January 2019.

 A better understanding of the relationship between food insecurity and cholera could inform both future cholera outbreak prediction and response, particularly in settings where poor food access and cholera risk factors are known to co-exist.