Ghana Identifies 93 High-Risk Districts in Cholera Control Strategy Backed by WHO

In a decisive move to eliminate cholera as a public health threat, Ghana has identified 93 high-risk districts for targeted interventions under a data-driven national strategy aligned with global efforts to end the disease.

The milestone follows the successful completion of a Priority Areas for Multi-sectoral Interventions (PAMI) exercise in March 2026, conducted with technical support from the World Health Organization (WHO) and funding from the Global Task Force on Cholera Control (GTFCC).

Data-Driven Strategy to Prevent Nearly All Cases

The exercise analysed cholera trends across 261 districts over a five-year period (2020–2025), using the internationally recognised GTFCC PAMI tool.

Districts were evaluated based on:

• Disease burden and case incidence

• Mortality rates

• Transmission dynamics

• Laboratory confirmation of cases

Following validation, stakeholders established a threshold indicating that targeting these identified districts could prevent up to 98% of cholera cases and 100% of deaths nationwide—a breakthrough in precision public health planning.

Multi-Sector Collaboration at the Core

The initiative brought together a wide coalition of stakeholders, including:

• Ministry of Health Ghana and Ghana Health Service

• Water and sanitation agencies

• Environmental and local government bodies

• Statistical and meteorological services

• Civil society organisations and international partners

This whole-of-government and whole-of-society approach reflects the understanding that cholera is not just a health issue, but a multi-sectoral challenge linked to water, sanitation, climate, and infrastructure.

Targeted Interventions to Follow

The identified priority districts will form the backbone of Ghana's upcoming National Cholera Control Plan, which will focus on cost-effective, high-impact interventions such as:

• Strengthened disease surveillance and early warning systems

• Health system capacity building and rapid response mechanisms

• Deployment of oral cholera vaccines (OCV)

• Improved water, sanitation, and hygiene (WASH) infrastructure

• Community awareness and behavioural change programmes

By concentrating resources where risk is highest, Ghana aims to maximise impact while ensuring efficient use of funding.

Strengthening Coordination and Ownership

Beyond its technical outcomes, the PAMI exercise has reinforced institutional collaboration and shared accountability.

Mr. Jonathan Akwabeng-Manu of Ghana's Environmental Health and Sanitation Directorate emphasised the importance of coordinated action, noting that the initiative enables stakeholders to align and integrate their interventions effectively.

Dr. Fred Kapaya from the WHO Nairobi Emergency Hub praised the process, highlighting the strong collaboration and consensus-building that will support the next phase—implementation of the national control plan.

Aligning with Global Cholera Elimination Goals

Ghana's strategy is aligned with the GTFCC Roadmap to End Cholera, a global initiative aiming to reduce cholera deaths by 90% and eliminate transmission in multiple countries by 2030.

By adopting a data-driven, district-level targeting approach, Ghana is positioning itself as a model for other countries battling recurrent cholera outbreaks.

A Critical Step Toward Public Health Security

Cholera remains a major public health challenge in many parts of the world, particularly in areas with inadequate sanitation and vulnerable infrastructure.

Ghana's identification of priority districts marks a crucial transition:

• From reactive outbreak response

• To proactive, preventive public health planning

With strong political commitment, international support, and a clear evidence base, the country is taking a major step toward eliminating cholera and strengthening long-term health security.