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Review
. 2018 Dec 4;18(1):1338.
doi: 10.1186/s12889-018-6227-6.

The cholera outbreak in Yemen: lessons learned and way forward

Frederik Federspiel  1 , Mohammad Ali  2
Affiliations
Review

The cholera outbreak in Yemen: lessons learned and way forward

Frederik Federspiel et al. BMC Public Health. .

Abstract

The Yemen cholera outbreak has been driven by years of conflict and has now become the largest in epidemiologically recorded history with more than 1.2 million cases since the beginning of the outbreak in April, 2017. In this report we review and discuss the cholera management strategies applied by the major international humanitarian health organizations present in Yemen. We find the response by the organizations examined to have been more focused on case management than on outbreak prevention. Oral Cholera Vaccines (OCVs) were not delivered until nearly 16 months into the outbreak. A recent scale-up of the global OCV stockpile will hopefully allow for rapid mass deployment of the OCV in future humanitarian emergencies. Continuous funding to this stockpile will be crucial to maintain this option for prevention and control of cholera outbreaks. Of equal importance will be the timely recognition of the need for mass OCV deployment and development of more specific, comprehensive and actionable evidence-based frameworks to help guide this decision, however difficult this may be. The outbreak highlights the importance for international humanitarian health organizations to have a continuous discussion about whether and to what extent they should increase their focus on pre-emptively addressing the environmental determinants of communicable diseases in humanitarian emergencies. Strong advocacy from the public health community for peace and the protection of human health, by bringing to attention the public health impacts of armed conflict and keeping the world's political leaders accountable to their actions, will remain crucial.

Keywords: Cholera; Conflict; Humanitarian response; Oral cholera vaccination; WaSH; Yemen.

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Conflict of interest statement

Authors’ information

Dr. Frederik Federspiel, MD, MPH, is a PhD Candidate in Public Health and Policy at the London School of Hygiene & Tropical Medicine. He conducted research on cholera under the supervision of Dr’s Mohammad Ali and David Sack during his MPH studies at the Johns Hopkins Bloomberg School of Public Health. Dr. Mohammad Ali, MA, PhD, is a Senior Scientist at the Dept. of International Health at the Johns Hopkins Bloomberg School of Public Health. Dr. Ali is the author and co-author of more than 60 publications on cholera and is a senior member of the Delivering Oral Vaccine Effectively (DOVE) Project.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. UN News. Yemen 2018 [Available from: https://news.un.org/en/focus/yemen. Last Accessed 2018 Apr 26].
    1. Save the Children. Yemen: Cholera Outbreak now Largest and Fastest on Record, 600,000 Children Infected by Christmas 2017 [Available from: https://www.savethechildren.net/article/yemen-cholera-outbreak-now-large.... Last Accessed 2018 Jan 2].
    1. WHO. Statement by UNICEF Executive Director, Anthony Lake, WFP Executive Director, David Beasley and WHO Director-General, Dr Tedros Adhanom Ghebreyesus, following their joint visit to Yemen 2017 [Available from: http://www.who.int/en/news-room/detail/26-07-2017-statement-by-unicef-ex.... Last Accessed 2018 May 8].
    1. WHO. Outbreak update – Cholera in Yemen, 25 October 2018 [Available from: http://www.emro.who.int/ar/pandemic-epidemic-diseases/cholera/outbreak-u.... Last Accessed 2018 Nov 4].
    1. WHO. Yemen Cholera Response - Weekly Epidemiological Bulletin 2018 [Available from: http://www.emro.who.int/images/stories/yemen/week_26.pdf?ua=1. Last Accessed 2018 Oct 19].

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