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2.The ‘Sword and Shield’ Approach to Cholera: Key Actions for Cholera Prevention and Response

About Key Actions

Based on best practice in the region, the recommended approach for managing Cholera is the “Sword and Shield”. This approach highlights the need for ongoing, cross-sectorial activities throughout the year, as opposed to sectorial approaches that are implemented once the caseload starts to go up, which is too late.The Sword and Shield is characterized by its targeting both on inter epidemic and epidemic periods respectively similar to a shield (prevention, containment and protection of population) and sword (attacking and breaking the spread of the epidemic). It focuses on individual practices and collective events, in rural or urban cholera high-risk spaces with pools of standing water, epicenters or corridors of propagation. In line with this approach, UNICEF response should incorporate WASH, Health and C4D sectors for effective results for children. Principles of the approach are Preparedness (action needs to be taken before cholera cases are reported), Knowledge (of the disease’s patterns and vulnerable locations), Mobility (in prevention and response), Anticipation and Reactivity (towards suspected outbreaks and spread of the disease), and continuous Targeting on dynamic transmission context and Realignment of the response.