Summary: DRC 2025 Anticipatory Action Framework

Getting Ahead of Large Cholera Outbreaks

Today, we can predict with increasing confidence the occurrence and humanitarian impact of a wide range of shocks, including large communicable disease outbreaks. The trajectory as well as the projected impact of these events can proactively be mitigated based on pre-identified anticipatory actions. Building on growing evidence that acting prior to the onset of a predictable, specific, and severe hazard is significantly faster, more efficient and dignified than traditional humanitarian responses, OCHA is facilitating the setup of multiple anticipatory action frameworks that methodically combine:

Risk analysis with a clear decision-making process (the trigger mechanism).

Pre-agreed actions that can alter the trajectory of the crisis (the anticipatory activities).

Pre-arranged finance, including by CERF.

The Humanitarian Coordinator leads the cholera framework for the Democratic Republic of the Congo (DRC). The framework is set up to anticipate and prevent large outbreaks in both endemic and non-endemic regions. OCHA, UNICEF and WHO have collaborated with the government and local implementing partners to catch cases earlier at the local level, cut transmission chains, and avoid the type of spread that could lead to a larger and harder to control outbreak. A rigorous learning and evaluation plan is in place to assess the impact of anticipatory action. Following two successful activations that demonstrated the effectiveness of the approach, the framework was revised in 2025 to incorporate lessons learned.

The Trigger Mechanism

Knowing when to act

The revised framework includes two scenarios, each of which can independently trigger an activation. Both scenarios are triggered on the basis of observational epidemiological data provided by the National Program for the Elimination of Cholera and the Control of Other Diarrheal Diseases (PNECHOL-MD): one targeting an increased risk for a large outbreak in endemic (North and South Kivu, Tanganyika, Haut-Lomami and Haut-Katanga) and the other focused on non-endemic provinces (the rest of the country). Triggers have been designed to allow agencies and partners to act much earlier and ensure that a small cluster of cases does not escalate into a major outbreak.