Cholera and the case for anticipatory action: Lessons from the Democratic Republic of the Congo

To prevent large-scale cholera outbreaks in the Democratic Republic of the Congo (DRC), the UN Central Emergency Response Fund (CERF) released four allocations over the past three years as part of an anticipatory action framework that contained cholera outbreaks, saved lives and maximized the impact of limited resources.

In May 2025, CERF provided US$750,000 to assist 139,000 people at risk of cholera in the DRC’s Maniema and Tshopo Provinces. This followed CERF’s $750,000 allocation two months earlier to support 122,000 people at risk in North Kivu Province.

This builds on a pilot in the DRC from 2022 to 2024, facilitated by OCHA in collaboration with the DRC’s National Cholera Elimination Plan, the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO). CERF released $1.5 million in 2023 when cholera cases were starting to increase in North Kivu, South Kivu and Tanganyika Provinces, enabling partners to respond within days, not weeks. They reached 455,000 people with safe water, rapid treatment and targeted public health measures. Case-fatality rates dropped and the spread of cholera reduced.

“In a resource-constrained environment, reducing humanitarian needs is more imperative than ever. This means not only responding to acute crises but also preventing them and addressing their underlying drivers. Anticipatory action is a vital part of the humanitarian toolbox. For example, it can help prevent a large-scale cholera outbreak before it escalates – saving lives and significantly reducing emergency response costs.”

The DRC’s experience offers more than a success story – it provides a scalable model. This case study examines how the approach was developed, how it worked in practice and what lessons it offers for the future. It proves that acting ahead of disease outbreaks is both possible and cost-effective. With cholera cases rising globally, now is the moment to match innovation with investment to ensure acting early becomes the norm.