In the Democratic Republic of the Congo (DRC), cholera continues to be a recurring and deadly threat. However, a new approach supported by the UN Central Emergency Response Fund (CERF) is showing that with timely intervention, outbreaks can be contained before they spiral out of control. Over the past three years, this innovative method has proven both lifesaving and cost-effective.
In 2025, CERF released $750,000 twice in March and again in May to respond to rising cholera cases in the provinces of North Kivu, Maniema, and Tshopo. This builds on a 2023 pilot that provided $1.5 million to combat increasing cases in North Kivu, South Kivu, and Tanganyika. The initiative reached over 450,000 people with clean water, rapid treatment, and health services, saving lives and preventing widespread outbreaks while keeping costs low.
“In a resource-constrained environment, reducing humanitarian needs is more imperative than ever,” said Bruno Lemarquis, the UN’s top humanitarian official in the DRC. “Anticipatory action can help prevent large-scale cholera outbreaks before they escalate saving lives and reducing emergency response costs.”
Cholera is an acute diarrhoeal disease that can kill within hours if untreated but is easily preventable through access to clean water and sanitation. Unfortunately, millions in crisis-hit areas still lack these basic needs due to conflict, poverty, and fragile health systems. Climate disasters such as floods make matters worse, creating ideal conditions for cholera to spread.
Despite the clear risks, prevention efforts remain severely underfunded. In Africa, national cholera plans receive only about 16 percent of required funding, forcing responses to begin only after outbreaks become widespread and more difficult to manage. Research indicates that up to 40 percent of deaths could be avoided with earlier interventions, highlighting the importance of swift action.
One major barrier to early response has been the lack of localized data. National reports often fail to capture the first signs of outbreaks at the community level, delaying funding and response. To address this, OCHA partnered with the DRC’s National Programme for the Elimination of Cholera (PNECHOL-MD), UNICEF, and WHO in 2022 to create an anticipatory action system.
This pilot program linked local data monitoring with automatic CERF fund releases once certain thresholds were met. In January 2023, it was activated in the Nyiragongo Health Zone, triggering $750,000 in aid. Within days, partners reached over 230,000 people with testing, water purification, and sanitation support. Eighteen new cholera treatment centers were established, and public health messages reached nearly 860,000 people. The fatality rate dropped to just 0.27 percent well below the global threshold of 1 percent.
A few months later, another activation in Tanganyika Province released another $750,000, assisting over 225,000 people. Communities received chlorinated water points, new wells, and awareness programs in schools and markets. More than 5,300 patients were treated, bringing the outbreak under control across all five affected zones.
The DRC pilot demonstrated that early intervention not only saves lives but also reduces costs and human suffering. A 2024 study further found that anticipatory action could reduce gender-based violence risks by eliminating the need for long, unsafe trips to fetch firewood for boiling water.
Following its success, the DRC has rolled out a revised anticipatory action framework in 2025, while similar plans are being developed in Mozambique and other countries. The initiative, supported by OCHA, UNICEF, WHO, and the Red Cross, underscores a powerful lesson: acting early is far more effective and humane than waiting for crises to unfold.
Now, as the global humanitarian community faces growing challenges, the DRC’s success story stands as a call to action. Investing in anticipatory systems could redefine how the world responds to preventable diseases like cholera turning early action into the new standard for saving lives.