1. The shield and sword strategy to control and prevent cholera

The cholera platform is promoting an integrated and targeted approach to control and prevent cholera outbreaks known as the “shield and sword strategy”. The approach is based on the integration of WASH and Epidemiological fields and on targeting high risk areas, population and practices. The sword is an intervention during an outbreak in affected areas, from the first suspected cases that allows a short delay in response and which is based on case investigation and mapping. The shield is characterized by sustainable preventive Water, Sanitation and Hygiene interventions outside of epidemic periods in the priority areas defined as being specifically at risk for cholera. The shield is also implemented during emergency situations and its aim is to prevent the spread of outbreaks by protecting populations not yet affected.

Summary of the approach

Strategy development involves a risk-informed and evidence-based approach, through continued operational research and pluri-disciplinary studies that support expanding knowledge and efficiency in cholera preparedness, emergency response and long-term intervention.
Epidemiologists, WASH specialists, health professionals, anthropologists and community mobilization specialists work together to achieve a common goal: elimination of cholera.
The “Sword” aspect involves intervention during an outbreak in affected areas, as soon as the first suspected cases are reported, thereby enabling a short delay in response based on case investigation and mapping.
The “Shield” feature is characterized by sustainable and preventive WASH interventions conducted outside of epidemic periods in priority areas, which are defined as specifically at risk for cholera. The “shield” approach is also implemented during emergency situations to prevent the spread of outbreaks by protecting unaffected but high-risk populations.

Download the brochure " Strategy to control and prevent Cholera in West and Central Africa"

Download the roadmap " West and Central Africa Regional Cholera Prevention and Response Integrated Strategy"

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