Early in September, the Ministry of Health in Tanzania Mainland embarked on finalizing development of its National Multi-Sectoral Cholera Prevention and Control Plan (NMCPCP).  Adopting a multi-sectoral approach to fighting cholera, the plan identifies and strengthens the linkages among government departments, multi and bi lateral development partners, Non-Governmental Organizations (NGOs), whose actions contribute to the reduction of risk of cholera and prevention at local and national levels. 

The process of developing this plan began in 2019 involving a series of consultative workshops with different local stakeholders and culminated with the recently held workshop in Arusha to finalize the plan. Through a multi-sector approach with well-coordinated roles and functions of different partners, the plan aims to reduce morbidity and mortality from cholera by 90%, contain and prevent cholera transmission.

The Disaster Response Coordination Unit from the Prime Minister’s office, the President’s Office Regional Administration and Local Government were involved in the process of developing the strategic plan, therefore giving the new plan a stage for more efficient coordination and involvement of all relevant sector ministries and departments at central and local governments level.

This multi-sectoral plan has been developed based on the cholera After Action Review (AAR) which was done in August 2017 and lessons learned during the previous responses to cholera outbreak. The plan considers the national and subnational levels,

This plan intends to fight cholera in Tanzania through a well-coordinated multi-sectoral approach that emphasizes a continuous prevention effort rather than the traditional focus on outbreak response only. Efforts will focus on 17 cholera high risk areas (hotspots) that include those commonly affected by floods and drought, low income urban areas, refugee camps, and cross border interventions.

The plan further focuses on the evidence-based priority interventions which include: multisectoral coordination, surveillance and laboratory, water, sanitation and hygiene (WASH) and social mobilization and community engagement.

In order to overcome dependence on a central management system, the plan emphasizes the strengthening of capacity at the subnational evel to diagnose, manage, control and prevent cholera. 

 “The revised plan addresses the challenges of the previous plan taking into considerations the evidence-based interventions and recommendations from different sectors and from the global roadmap to end cholera by 2030,” said Dr Leonard Subi, Director of Preventive Services in MoH.

This five-year plan (2019 -2023) targets to lay a foundation and a roadmap towards elimination of cholera in Tanzania and achievement of the global goal of ending cholera by 2030.

“We have built in multisectoral involvement in the new strategic plan. We take advantage of the disaster response coordination unit in the Prime Minister’s Office and brought in the Ministry of Health, Ministry of Water and other stakeholders,” said Valentina Sanga, an Epidemiologist from the Prime Minister’s Office.

Cholera remains a significant public health threat of concern in Tanzania. The longest spell lasted from August 2015 to December 2018 and affected all the 26 regions and 129 (out of 139) districts of Tanzania.

“If we implement this plan, we will record the end of cholera in Tanzania as a public health problem leading to total elimination. I learned a lot about coordinating involvement of players beyond health sector during response to an outbreak in Ngorongoro which is a hotspot,” said Ango Mwamafupa, Regional Health Administrator in Arusha region.