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Zimbabwe multi-sectoral: Cholera elimination plan (2018 - 2028)

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Zimbabwe
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Govt. Zimbabwe
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As the Government of Zimbabwe, we recognise that the health of a nation is critical to its development. In line with Sustainable Development Goal #3, we are committed to ‘Ensure healthy lives and promote wellbeing for all at all ages’. This is articulated in the National Health Strategy 2016-2020 Equity and Quality of Health: Leaving No One Behind. In order for us to leave no one behind our approach needs to be comprehensive and strategic, tackling the myriad diseases and illnesses affecting our people, of which cholera is one.

Although it is considered a medieval disease, cholera continues to be a major public health threat with a global presence. Across the globe an estimated four million cholera cases and over 140,000 deaths are reported each year. Africa sees a large number of these cases with 17 countries affected by cholera with over 150,000 cases, resulting in 3000 deaths.

Zimbabwe is among those impacted by the scourge of cholera with outbreaks following a somewhat cyclical pattern, coinciding with the rain season. The last 10 years have seen two major outbreaks, one in 2008/09 which resulted in over 100,000 cases including over 4,000 deaths, and another in 2018/19, where there were 10,000 cases with 69 deaths across the 21 cholera hotspot districts in the country, with the nation’s capital Harare, among the worst affected.

The most recent outbreak in 2018, brought us to the realization and the need for lasting solutions to dealing with cholera in our country. His Excellency, The President instructed the instructed my cabinet to set up an interim inter-ministerial committee seized with both the short term and long term solutions to end cholera in Zimbabwe. Our interventions in 2018 taught us that there was a need for a multi-stakeholder approach that involves government, the private sector and development partners. Through the Cholera Secretariat of Zimbabwe we convened a National Task-Force for Cholera Elimination which put together this Multi-Sectoral Cholera Elimination Plan for Zimbabwe.

Following the outbreak in 2018, we understood the need for lasting solutions to dealing with cholera in our country. I instructed my cabinet to set up an interim inter-ministerial committee seized with both the short term and long term solutions to end cholera in Zimbabwe. Our interventions in 2018 taught us that there was need for a multi-stakeholder approach that involves government, the private sector and development partners. Through the Cholera Secretariat of Zimbabwe we convened a National Task-Force for Cholera Elimination which put together this Multi-Sectoral Cholera Elimination Plan for Zimbabwe.

This document outlines the roadmap for Zimbabwe to eliminate cholera in line with our 10 Year Promise to eliminate cholera by 2028. In keeping with international best practices, our plan is guided by the Global Task Force on Cholera Control (GTFCC) global roadmap. We recognise that eliminating cholera requires concerted efforts to prevent the disease by implementing a variety of measures - such as long term Water, Sanitation and Hygiene (WASH) in areas most affected by cholera, and by containing outbreaks through early detection and rapid response to alerts. Additionally, there is the need for an effective mechanism of coordination for technical support, resource mobilisation and partnership at the local and national levels.

Our approach brings together the necessary players and actors across five pillars critical to the elimination of cholera: 1) Public Health Emergency Preparedness and Response, 2) Water, Sanitation and Hygiene (WASH), 3) Infrastructure Rehabilitation, 4) Community Empowerment and 5) Innovative Financing and Resource Mobilisation. We need to solve the challenge of access to clean and safe water and sanitation, a critical component in the fight against cholera. Part of the WASH interventions requires us to fix the infrastructural challenges that affect the provision of clean water to the public. In addition, we need strong public health systems and dynamic advocacy and community participation to ensure that our work is a success.

Zimbabwe is also seized with strengthening surveillance and laboratory capacity to ensure early detection and quick response to contain outbreaks at early stages. Our commitment to the development of the Public Health Emergency Operations centre (PHEOC) is part of this system's strengthening that will assist in how we deal with outbreaks should they occur.

The government firmly believes that the plight of cholera is not something that should be affecting our country in this present day and so we have a commitment to our people to eliminate the disease by 2028. Achieving this goal will assist us to realise the vision of Zimbabwe attaining upper middle income status by 2030. This plan is critical to our efforts and we look forward to its implementation and seeing a cholera free Zimbabwe by 2028.