Mozambique Anticipatory Action Framework for Cholera (2026)

Country: Mozambique Source: UN Office for the Coordination of Humanitarian Affairs Please refer to the attached file. 1. Executive Summary The context: Cholera remains a major and preventable public health threat in Mozambique, where recurrent outbreaks are driven by limited access to safe water, sanitation and hygiene (WASH), constrained health services, and frequent climate related shocks such as floods and cyclones. The disease is endemic, with annual outbreaks during the rainy season— particularly in Cabo Delgado, Nampula, Sofala and Tete provinces—and has escalated significantly in recent years. From September 2022 to July 2024, the country experienced its largest outbreak in two decades, with more than 48,700 cases reported across 93 districts, followed by continued transmission through 2025. The objective: The objective of this framework is to enable rapid, coordinated anticipatory action to reduce the scale and severity of potential large, out-of-the-ordinary cholera outbreaks in Mozambique. By acting during the early stages of abnormal transmission patterns—before outbreaks escalate—partners aim to prevent large-scale spread, reduce mortality, and protect vulnerable communities. The development process: The framework was developed through a participatory process led by the Resident and Humanitarian Coordinator. With support from OCHA, its development involved the Ministry of Health (MISAU), the National Institute of Health (INS), UNICEF, and WHO. Clusters and local partners such as the Mozambique Red Cross were also consulted. The trigger: The trigger mechanism relies on weekly epidemiological surveillance data shared by national health authorities. Complex models that attempt to predict cholera outbreaks are not yet reliable enough to serve as triggers in thi...

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