Bulawayo – The Ministry of Health and Child Care (MoHCC) in Zimbabwe with support from the World Health Organization and UNICEF conducted an Intra Action Review (IAR) of the current cholera response in the country from 3-7 June 2024. This IAR served as a platform for key responders to collaboratively assess strategies, share experiences, pinpoint challenges, and identify successful actions. These insights will be used to refine programme decisions and control the outbreak more effectively.

The country-led review brought together key stakeholders, decision makers, and implementing partners including experts from technical agencies including the Africa CDC, IFRC, Medecins Sans Frontiers (MSF), UNICEF, World Vision, and WHO.  

MoHCC Cholera Incident Manager Dr Isaac Phiri said the review is a stock taking opportunity that will help the country accelerate efforts to control the outbreak particularly at the time when the country is recording a decline in cases.

“The IAR is important for us to restrategize our response and curb this outbreak preferably in the next six weeks. We also thank WHO and all our partners providing technical support needed in critical situations like this,” he said.

The review was conducted using a combination of presentations, group work and plenary sessions from various pillars including Coordination, Risk Communication and Community Engagement, Laboratory, Surveillance, Operational Support and Logistics, as well as the Case Management. Numerous challenges including insufficient public health structures, particularly those related to Water, Sanitation, and Hygiene (WASH) to effectively contain the spread of cholera were highlighted. In addition, the review noted delays in last mile distribution of cholera supplies and commodities hindering effective outbreak response while inconsistencies and limitations in communication strategies hindered public awareness and community engagement efforts in some areas.

The review highlighted several success stories. The activation of the incident management system, identified as a key strength, was facilitating improved coordination of the response including resource tracking. Additionally, a robust case management system, with trained personnel, effectively treated cholera patients. The IAR also revealed good practices in the surveillance system that enabled timely detection and tracking of cholera cases. Furthermore, the engagement of interfaith leaders improved community engagement activities on cholera prevention, with traditional leaders playing a key role in engaging communities.

 “This was a great platform for sharing information and good practices critical to accelerate our response efforts and end this outbreak. A lot of learning was done even outside the workshop formal engagements,” noted one of the participants John Mwenda, a Medical Research Officer from the National Institute of Health Research.

WHO Member States at the May 2020 World Health Assembly recommended a periodic IAR of the health response to COVID-19 and this has been cascaded down to other emergencies such as cholera outbreaks when they become protracted. WHO has been supporting MoHCC since the beginning of the outbreak in February 2023 through provision of up-to-date guidelines on best practices for cholera prevention, control, and treatment, essential cholera supplies including oral cholera vaccines, rehydration solutions, and diagnostic tests, deployment of technical experts to support national and local authorities in outbreak response activities as well as advocating for increased funding and resources to support cholera control efforts.

“The IAR was very successful and highlighted priority actions based on the challenges identified in the cholera response.  WHO and partners look forward to supporting MOHCC and subnational stakeholders work on the recommendations and bridge the gaps identified to contain the outbreak,” said Dr Sally-Ann Ohene.