Current Research in Emergency Medicine
[ ISSN : 2832-5699 ]
Paper Title: Emergency Cholera Response in South Sudan: Challenges, Risks, Mitigation Measures and the Way Forward
1Senior Consultant, Global Fund–ICHESS Technical Assistance Programme, Ministry of Health, Republic of South Sudan, Juba, South Sudan
2Chief Executive Officer (CEO), Sam-Divine Health Vanguard International CIC, Newcastle upon Tyne, United Kingdom
Corresponding Authors
Keywords
Abstract
Background: South Sudan continues to experience recurrent cholera outbreaks driven by protracted conflict, population displacement, climate-related flooding, and fragile health and water systems. Despite repeated emergency responses, cholera remains a leading cause of preventable morbidity and mortality.
Objective: To analyze recent cholera outbreaks in South Sudan, assess emergency response performance, identify key challenges and risks, and propose evidence-based strategies to strengthen prevention, preparedness, and control under Ministry of Health leadership.
Methods: A narrative policy and practice review was conducted using Ministry of Health cholera situation reports, WHO and UNICEF epidemiological updates, Integrated Disease Surveillance and Response (IDSR) data, Oral Cholera Vaccination (OCV) campaign documentation, and peer-reviewed literature. Data were synthesized across epidemiology, emergency response actions, health system performance, and preparedness domains.
Results: The 2024-2025 outbreak was the largest recorded in South Sudan, affecting more than 50 counties across at least nine states. National Case-Fatality Rates (CFRs) ranged from 1.3% to 2.0%, exceeding recommended emergency thresholds during early phases. Emergency measures-including cholera treatment centres, oral rehydration points, rapid response teams, WASH interventions, and reactive OCV campaigns-reduced facility-based mortality. However, delayed care-seeking, weak community surveillance, and limited decentralized capacity sustained community-level deaths and recurrent transmission.
Conclusion: Cholera in South Sudan represents a chronic systems emergency rather than episodic outbreaks. Sustainable control requires a transition from reactive emergency response to nationally led, multi-sectoral preparedness anchored in primary health care, community platforms, and resilient WASH systems. Integrating surveillance, decentralized emergency care, and strategic OCV use in line with global frameworks is essential to preventing future outbreaks and strengthening overall health security.