Intersectoral actions in response to cholera in Zimbabwe: From emergency response to institution building
Executive Summary
Between August 2008 and July 2009, Zimbabwe experienced a catastrophic cholera outbreak that resulted in almost 100,000 cases and over 4000 deaths. A national emergency was declared in December 2008, paving the way for a widespread multi-sectoral response to deal with the outbreak that was affecting nearly every district in the country and overwhelming the Ministry of Health and Child Welfare’s capacity to respond. At the same time as instituting a comprehensive emergency response, it was important to build inter-sectoral action to address the social determinants of health driving the outbreak (including water and sanitation, poor hygiene practices), particularly given the prevailing context of poverty and national systemic constraints that accompanied the outbreak.
The emergency declaration led to the establishment of a multi-sectoral government task force under the leadership of local government. The Ministry of Health and Child Welfare took the key leadership and coordination role across all stakeholders, with the support of a wide range of Government Ministries, United Nations Agencies, donors, bilateral governments and agencies, Non-governmental Organizations and Community Based Organizations. A Cholera Command and Control Centre (C4) was established to give technical guidance and coordination support to the response, bringing together the support of a WASH cluster, Health Cluster and Logistics Cluster, and mobilizing technical and financial resources for work to be done.
Action was taken across a wide range of sectors including to address thematic areas of surveillance and laboratory, case management, Water, Sanitation and Hygiene (WASH), social mobilization and logistics.
By July 2009 the cholera outbreak was declared over, although the country remains vigilant and engaged in ongoing efforts to improve preparedness to respond to future outbreaks as well as address the social determinants of health driving the original outbreak, in particular water and sanitation. Additional impacts observed as a result of the response included the improved and harmonized action of multiple stakeholders, and strengthening of the health system.