Devex Checkup: ‘Turbocharged’ cholera wreaking havoc in a warming world

After years of decline, cholera is on the rise — and experts chalk this increase up to climate change as waters warm and violent weather becomes the norm.

Twenty-nine countries have reported cases of cholera already this year — some of which, such as Haiti, Syria, and Lebanon, haven't seen an outbreak in years. Over the past five years, an average of less than 20 countries reported outbreaks per year. Furthermore, the average case fatality rate this year is nearly three times the rate seen during the past five years.  

“We've seen a dramatic increase in the number of cases of cholera,” UNICEF health specialist Raoul Kamadjeu tells Sara, echoing the words of World Health Organization chief Tedros Adhanom Ghebreyesus, who said cholera was being “turbocharged by climate change.”

• It’s a water-borne disease, and populations of cholera-causing bacteria increase as water temperatures rise. Floods, monsoons, cyclones, and hurricanes stir up sediment and contaminate water. They also destroy water and sanitation infrastructure — often leeching sewage into the water. When there is drought, people are often left with only sediment-rich, contaminated water.

• These weather events spur widespread migration. Displacement camps are often crowded with inadequate sanitation — becoming breeding grounds for cholera. And because of the uptick in cases, demand is so high for cholera vaccines that WHO and its partners said there aren’t enough, so it lowered the recommended doses from two to one to broaden access.

• Cholera is particularly dangerous for malnourished children. "If they get cholera and don't go directly to the health center, they will die in hours," says IFRC’s Alexandra Machado.  

Read: Cholera thrives in a warming world

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Penny pinching 

The Financial Intermediary Fund for Pandemic Prevention, Preparedness and Response is underfunded — by a lot, our colleague Shabtai Gold writes. Donors have given just $1.4 billion of the $10.5 billion it needs annually. It's a trust fund that pools public and private money to prevent, prepare for, and respond to future pandemics. While the intention was that countries would allocate new money to this fund, there is a temptation for high-income governments to just move funds around within existing budgets, according to Center for Global Development’s Peter Barker.

Read: The pandemic readiness fund is short on cash. It's not the only issue. (Pro)

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Somalia deteriorating

In Somalia’s devastating drought, child mortality has increased significantly, Mohamed writes in an op-ed for Devex. More than 700 children have died in official nutrition centers — but that’s an underestimate, as many deaths are undocumented.

“In the camps, I met young children so malnourished and weak that they could barely stand. Some had not eaten for days or had survived on a diet of wild fruits that are not usually fit for humans to eat,” Mohamed writes.

Opinion: Somalia needs the world to wake up now

ICYMI: Sara visited drought-impacted communities in Mogadishu and Baidoa, Somalia in late August, when the situation was already dire. She also reported on the politics surrounding a famine declaration — and why the world shouldn’t wait for one before pumping in resources.

Getting their ACT-A together

Last month, we reported the transition plan for Access to COVID-19 Tools Accelerator, or ACT-A, will be out soon. We now know that it is expected to be announced tomorrow. Here are some questions we have in the meantime:

• “The ACT Accelerator has to change,” WHO’s Dr. Bruce Aylward, who coordinates the work of ACT-A, told our colleague Jenny Lei Ravelo. Aylward said that the initiative also plans to increase procurement and access to treatments. Will there be new structures put in place, and how will funding be organized?

• Aylward also said that the work of partner organizations, including Gavi, Unitaid, and the Global Fund might change over time. How will this be coordinated across agencies?

• In a separate interview, Dr. Ayoade Alakija, the WHO special envoy for ACT-A, told us that one of the key weaknesses of the initiative was poor communication that led to inequity. How will the transition plan tackle this?

• Earlier this month, two-thirds of the respondents of an independent evaluation felt that the ACT-A model should not be replicated — does the new plan address this concern?

Don’t miss our analysis of ACT-A’s transition plan in tomorrow’s Newswire. Sign up now to receive it.

Gates way

That’s how much money the Bill & Melinda Gates Foundation gave to the Institut Pasteur de Dakar to fund the technology transfer needed to manufacture measles and rubella vaccines for routine immunization campaigns in low- and middle-income countries.

The technology transfer will take one year and then production for trials and submission for regulatory approvals will commence, Dr. Joe Fitchett, senior adviser for biotechnology at the institute, tells Sara.

ICYMI: Senegal nears completion of 'bespoke' vaccine manufacturing facility (Pro)

Mushrooming problem  

WHO released its first list of 19 fungi that most threaten human health. Fungal pathogens are becoming more common and resistant to treatment, but there are only four classes of antifungal medicines on the market and a slim pipeline for new ones.  

What we’re reading

We may only have a few months to prevent the next pandemic, writes one doctor with experience battling epidemics. [The New York Times]

Merck says it has located a frozen batch of undisclosed Ebola vaccine, which will be donated for testing in Uganda’s outbreak. [Science]

Extreme flooding and other climate-related disasters are leading to explosive disease outbreaks. [Scientific American]