Continental Cholera Emergency Preparedness and Response Plan for Africa 1.0

Executive Summary

Cholera remains a major public health challenge in Africa, accounting for about 82% of global cases and 93.5% of cholera-related deaths. The burden falls disproportionately on fragile, conflict-affected, and underserved areas with limited access to clean water, sanitation, hygiene and essential health services. In response to this growing threat, African Heads of State and Government (HoSG) have elevated cholera to a continental priority, committing—through their recent high-level Call to Action—to control and eliminate outbreaks by 2030.

To translate this commitment into action, Africa CDC and the World Health Organization (WHO) have jointly put together a cholera continental preparedness and response plan for cholera control, while also Africa CDC and WHO jointly establishing a Continental Cholera Incident Management Support Team (IMST), drawing on lessons from the continental mpox IMST. Instead of creating a separate structure, the Continental cholera IMST will be integrated into the existing mpox IMST platform, harnessing shared capacities, technical expertise, and coordination systems. This integrated approach will enhance efficiency, ensure strategic coherence, and optimize resources—critical in an era of rising outbreaks and constrained health financing. Additionally, the plan describes the roadmap towards cholera elimination by 2030 with the establishment of a Continental Task Force, led by Member States with Africa CDC and WHO providing secretariat support, to coordinate Member States’ efforts and drive longer-term interventions aimed at eliminating cholera as a public health threat across the continent by 2030. This is in alignment with the global cholera elimination plan. The roadmap envisions an Africa free of cholera outbreaks/epidemics, guided by three overarching goals of a reduction in cholera deaths by 90% and elimination of cholera in more than 20 countries, and maintaining a case fatality rate below 1%. The integrated continental IMST is designed to ensure seamless continuity of emergency response operations across multiple disease threats. It builds on the success of the mpox IMST, which coordinated responses across 26 countries during the 2024/2025 outbreak, under the “4-One” principle: one team, one plan, one budget, and one monitoring framework. This model enables streamlined decision-making, rapid deployment of interventions, joint resources mobilization, and clear accountability across Member States and partners. This document outlines the plan for a continental cholera prevention and control with the implementation framework for the Cholera IMST, detailing its governance structure, strategic priorities, and operational modalities. Key components include:

• Adaptation of Mpox IMST Standard Operating Procedures (SOPs) to incorporate cholera-specific functions and
  workflows.
• Inclusion of cholera experts in the IMST core team to provide technical leadership and guidance.
• Alignment of response pillars—including surveillance, case management, infection prevention and control (IPC),
  risk communication and community engagement (RCCE), logistics, and continuity of essential health services—to
  address cholera emergencies effectively.