How anticipatory action adds value to epidemic preparedness: managing cholera outbreaks in Cameroon
The Cameroon Red Cross Society’s Early Action Protocol (EAP) for Cholera marks a historic milestone: the first EAP for an epidemic to be validated by the International Federation of Red Cross and Red Crescent Societies (IFRC). This will enable the National Society to implement anticipatory actions ahead of a forecast cholera epidemic.
The EAP was developed under the RIPOSTE project, in collaboration with the French Red Cross, Cameroon’s Ministry of Health and Ministry of Energy and Water, the National Institute of Statistics, the World Health Organization, Médecins Sans Frontières and the Netherlands Red Cross’ data and digital team, 510. “Developing this EAP in a participatory manner was an enriching experience, enabling us to learn a great deal about anticipatory planning for epidemics,” says Cyrille Ewane Ngando, an epidemiologist and the cholera focal point at the Cameroon Red Cross Society.
Anticipating cholera epidemics
National Red Cross and Red Crescent Societies reduce health threats through measures such as improved access to healthcare and increasing community awareness of health risks. Now, trigger mechanisms – based on indicators that an epidemic is likely – are emerging as a new tool to mitigate these health crises before they escalate.
The EAP for Cholera integrates three types of data in its trigger mechanism:
- Climate risk data: by causing increasingly frequent and severe weather events, climate change influences the spread of cholera; this worsens existing vulnerabilities and creates new challenges for public health. The RIPOSTE project provides humanitarians with data on previous climate-related cholera outbreaks (as well as other climate-related events).
- Weather forecasts: these indicate when an extreme event is likely to occur.
- Community-based surveillance: volunteers from the Cameroon Red Cross Society collect community reports of disease symptoms in their local community and report these back to the National Society and Ministry of Health.
A data management system (EspoCRM), connected to a Power BI dashboard for data visualization, supports the Cameroon Red Cross Society in monitoring the data used in its triggers. By sending automatic alerts, this system allows its staff to monitor signs of an impending epidemic, such as increased rainfall or community-reported cholera cases.
The EAP also lists the anticipatory health interventions to be implemented once the trigger is activated. These include distributing water purification tablets, disinfecting water, sanitation and hygiene (WASH) infrastructure, and sensitizing communities to the risks.
“Thanks to a trigger system based on climatic and epidemiological data, this cholera EAP enables rapid interventions to limit the impact of the disease, reduce mortality and avoid the escalation of a health crisis. It represents a proactive response before an epidemic spreads.”
The road ahead
Cameroon’s EAP for Cholera, which integrates weather forecasts with historical climate data and community insights – all combined in a simple-to-use digital tool – sets a precedent for scaling up the anticipatory action approach across other countries and regions, and to other diseases. This in turn symbolizes the importance of embracing innovation in humanitarian action, which will help to ensure that National Societies can anticipate future epidemics, not just respond to them.
The EAP for Cholera was developed as part of the RIPOSTE project, which is led by the French Red Cross and funded by the French Development Agency. It explores how to use anticipatory action to manage epidemic outbreaks in four sub-Saharan countries: Cameroon, Chad, the Democratic Republic of Congo and Guinea. Its development was supported by health specialists from the Faculty for Public Health of the University of Rennes, as well as technical experts from the Netherlands Red Cross’ data and digital team, 510.
Photos from IFRC unless otherwise stated.
For further information, please contact:
- Mathilde Duchemin at the French Red Cross
- Aklilu Teklesadik at the Netherlands Red Cross.