Cholera is an acute diarrheal disease that can kill within hours if left untreated, and it is re-emerging around the world due to fast urbanization in developing countries and global warming. In 2011 more than half a million cholera cases were reported to WHO yet this only represents a small portion of the estimated 3-5 million cholera cases a year. Of these reported cases there were estimated 100,000-120,000 deaths per year.
The traditional focus has been on treatment of the disease, however, epidemiologists and engineers are trying to develop a longer term response by shifting the methodology from treatment to prevention. The approach combines epidemiology, water, sanitation, and hygiene, with an emphasis on careful observation.
Surveillance is paramount to identifying vulnerable populations living in hotspots and a multidisciplinary approach based on prevention preparedness and response is key to mitigating cholera outbreaks, controlling cholera in endemic areas and reducing death in a sustainable manner. Preventative actions include access to potable water, adequate sanitation and focused health education on personal hygiene practices.
The disease is a key indicator of social development and almost every developing country faces cholera outbreaks or the threat of a cholera epidemic. While no study has been undertaken to estimate the economic burden of cholera for use in advocacy in its prevention and control, research conducted by WHO African region representatives estimated the direct and indirect cost of cholera in the region: The 110,837 cases of cholera notified in 2007 resulted in an economic loss of between $43 and $73 million USD, depending on life expectancy. These costs included those born by the government as well as citizens and took into account among other variables, cost of operating health facilities and services, medicine, and time lost.
The Global Alliance Against Cholera is an international advisory group that works to identify “high risk” areas and the means to control the predictable cholera epidemics which are endemic to these locations. Its Strategic Plan has already been incorporated in Congolese national policies as the DRC stands among the countries most affected by cholera on a worldwide scale. Commitment to coordinated involvement by the principal national and international stakeholders in the DRC since the initiation of its Strategic Plan has resulted in a significant amount of financial leverage to continue this critical effort. Cholera is a preventable disease provided that safe water and proper sanitation are made available.