Afghanistan: Cholera preparedness and response strategy for the WHO Eastern Mediterranean Region, 2025-2028

Please refer to the attached file.

Acute watery diarrhoea (AWD)/cholera remains a significant public health concern in the WHO Eastern Mediterranean Region, with major outbreaks impacting multiple countries. The burden of cholera outbreaks has increased dramatically over the past few years. In 2024, nine countries – Afghanistan, Djibouti, Iraq, Lebanon, Pakistan, Somalia, Sudan, the Syrian Arab Republic and Yemen – reported almost 80% of the global burden of AWD/suspected cholera, with over 643 000 cases, including 2354 deaths.

Cholera outbreaks in the Region are driven by a complex interplay of environmental, economic, social and political factors. The key determinants of cholera in the Region include: 1) inadequate health system capacities; 2) inadequate water, sanitation and hygiene (WASH) in households, and WASH and infection prevention and control in health care facilities; 3) ineffective intersectoral coordination, partnerships and funding; and 4) other contributing factors such as climate change and environmental, governance, social and political factors that result in displacement and overcrowding, with inadequate access to WASH and health care, particularly in developing countries.