The Ending Cholera Roadmap aims to end cholera as a public health threat in up to 20 countries, reducing cholera deaths by 90% by the year 2030. To achieve this objective, engaged countries are developing National Cholera Elimination Plans. To assist countries to develop their national plan, the GTFCC has developed a Cholera Elimination Framework document, which includes templates and tools to guide countries through all steps of the process. During the meeting, the Cholera Elimination Framework was presented, along with the activities over the past year of the GTFCC working groups, including laboratory, surveillance, oral cholera vaccine (OCV), WASH (water, sanitation and hygiene) and case management.
An unprecedented number of countries aim to eliminate cholera. Zambia, Zanzibar and Zimbabwe are launching their elimination plans. Zambia plans to reduce morbidity and mortality and eventually eliminate cholera in the country by 2025. Zanzibar aims to eliminate local cholera transmission by 2028. Malawi has also set out to end cholera by 2030. Ethiopia, which until now only considered acute watery diarrhea, is finally set to declare cases of cholera.
Several countries reported significant progress in cholera control efforts, while other countries continue to struggle. Haiti has launched the last phase of their elimination plan and is making significant progress in case reduction (537,384 suspected cases from October 2010 to December 2011 vs. 4,152 suspected cases from January 2018 to May 18, 2019). Cholera case numbers in the DRC have decreased since 2017, with a total of 10,928 cases and 245 deaths reported from week 1 to week 20, 2019. Cholera transmission has stopped in South Sudan since late 2017. In Harare, Zimbabwe, the outbreak was controlled within two months. The situation is also improving in other countries such as Nigeria. However, cholera control continues to remain a major challenge in Yemen, where 353,079 suspected cases were reported from January 1 to May 26, 2019. During this time, children under five years of age represented 22.5% of all cases in the country.
Despite certain advances in cholera control, certain challenges still remain. Several countries have not yet committed to eliminating cholera. Furthermore, hotspots have not been identified in certain countries, thus limiting preparedness, prevention and control strategies. Furthermore, cholera surveillance is not standardized, and the vast majority of cholera cases are considered suspected cases. As a result, the next steps outlined during the meeting included supporting priority countries to implement the Roadmap and mobilizing other priority countries in the process of cholera elimination.