Home | Comment & Analysis    Saturday 9 September 2017

The UN’s WHO knows cholera vaccines have been used effectively: why not in Sudan?

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Eric Reeves

The UN’s World Health Organization (WHO) continues in its refusal to call the cholera epidemic that has spread throughout Sudan by its proper name (cholera is caused by the Vibrio cholera bacterium, easily identified in WHO’s Geneva laboratories).

WHO remains silent, refusing either to confirm or disconfirm the existence of cholera in Sudan. Give the continual reporting, for a year now, by Radio Dabanga and Sudan Tribune, about the existence of a cholera epidemic, it is indisputably WHO’s obligation to make a determination. From its silence we may infer two things:

[1] The ruthless National Islamic Front/National Congress Party regime in Khartoum knows there is a "stigmatizing" cholera epidemic, which is why it threatens health workers and reporters who dare use the word cholera, and has also succeeded in intimidating the WHO into not using the word cholera in any way.

[2] But given the widespread reporting of cholera epidemic in Sudan, WHO would certainly use fecal samples from victims of what they insist on calling “acute watery diarrhea” to disconfirm the existence of cholera, if it possibly could. But it can’t, so it maintains an unconscionable silence.

Why is it important that cholera be named? There are many reasons, including the urgent deployment of medical equipment (primarily massive quantities of re-hydration supplies and cholera treatment medicines) and knowledgeable medical personnel (including infectious disease specialists and epidemiologists familiar with the patterns associated with a cholera epidemic).

Critically, newly developed cholera vaccines could be used, particularly in populations most at risk (Kalma camp and Jebel Marra in Darfur, for example). But the vaccines won’t be distributed unless the disease from which they offer protection is named. WHO itself recognizes the value of such vaccines:

The UN World Health Organization on Cholera Vaccines:

Cholera vaccines | http://www.who.int/topics/cholera/vaccines/en/

In the long term, improvements in water supply, sanitation, food safety and community awareness of preventive measures are the best means of preventing cholera and other diarrhoeal diseases. However, WHO and partners are evaluating the use of newer tools to complement these traditional measures. Oral cholera vaccines of demonstrated safety and effectiveness have recently become available for use by individuals. Some countries have already used oral cholera vaccines to immunize populations considered to be at high risk for cholera outbreaks.

Evidence gained on the use of oral cholera vaccines is evolving rapidly. Work is under way to investigate the role of mass vaccination as a public health strategy for protecting at risk populations against cholera. Issues being addressed include logistics, cost, timing, vaccine production capacity, and criteria for use of mass vaccination to contain and prevent outbreaks.

• Potential use of oral cholera vaccines

• Currently available oral cholera vaccines

[Cholera vaccines are discussed in similar terms by the U.S. Center for Disease Control | https://www.cdc.gov/cholera/vaccines.html/]

The refusal to name the cholera epidemic in Sudan by its proper name is costing more lives and creating more human suffering daily.

Why won’t the UN World Health Organization fulfill its explicit mandate?

Our primary role is to direct and coordinate international health within the United Nations’ system.

Our goal is to build a better, healthier future for people all over the world. Working through offices in more than 150 countries, WHO staff work side by side with governments and other partners to ensure the highest attainable level of health for all people.

— 

Eric Reeves, Senior Fellow at Harvard University’s François-Xavier Bagnoud Center for Health and Human Rights



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