Continuing emergency response to cholera outbreaks in Angola


Location of operation: ANGOLA
Amount of Decision: EUR 1,500,000
Decision reference number: ECHO/AGO/BUD/2006/02000

Explanatory Memorandum

1 - Rationale, needs and target population.

1.1. - Rationale :

Extremely heavy rains over much of southern Africa since January, compounded by poverty, lack of basic sanitation facilities and low hygiene standards have resulted in more or less serious outbreaks of cholera in peri-urban areas of several cities. In Angola, peace came in April 2002 after almost thirty years of conflict which left the country devastated, with the provision of social services, such as basic health care and water and sanitation inexistent in most areas.

The first cholera outbreak was declared in the slum districts of Sambizanga and Ingombota (Boavista) in Luanda on February 13th. Luanda's vast slums are home to upwards of 3 million people, mostly former IDPs from the first phases of the conflict who settled two or three decades ago in areas with no drainage, potable water supply or rubbish collection facilities. The combined intervention of the Government, UN agencies and NGOs initially succeeded in bringing about a stabilization of the situation at less than 100 cases a week until early April. Since then, however, the outbreak has spread extremely rapidly to other areas of the city, and the number of cases has risen incrementally to reach 1,500 by 15th April, reaching 1.000 cases a day nationally by the end of April and into the first 10 days of May before decreasing slightly. For the purposes of this decision, therefore, the epidemic can be said to have reached emergency proportions as of 15th April.

Since early April also, outbreaks have been declared in 10 other provinces of Angola - Bié, Bengo, Benguela, Huambo, Huila, Kwanza Norte, Kwanza Sul, Malanje, Uige, Zaire - with the situation having been particularly worrying in Benguela (almost 7200 cases, of which 495 deaths, a case fatality rate of 6%).

According to information issued by the Word Health Organisation on 18th May, 546 cases and 31 deaths were recorded nationally on 17th May alone. The cumulative total from 13th February stands at 35.775 cases, of which 1.298 deaths, giving a case fatality rate at national level of 3.6%. This is in excess of the 30.000 cases forecast by epidemiologists in mid-April, and it is now thought that as many more new cases are likely over the next two/three months.

Against the background of this alarming and extremely rapid spread, and the weak capacity of the Government to cope with so many outbreaks at the same time, UN agencies and nongovernmental organizations have continued to scale up their existing interventions and established new intervention sites in the eleven provinces thus far affected. This substantial emergency scaling up includes the redeployment of medical teams within Angola and from Europe, and the dispatch of large quantities of ringer lactate, oral rehydration salts and other essential items from Europe, as such stocks are insufficient or completely absent in many areas.

DG ECHO(1), in an emergency funding decision adopted on 12th May but announced on 21st April, already made available 1.5 MEUR to contribute to providing the necessary capacity for the early containment of the existing outbreaks. At that stage, and in the light of the rapid progression of the disease, the possibility of mobilizing additional resources was not excluded.

The Government of Angola at the end of April released US$ 5 million for nationwide interventions to provide clean water and collect rubbish.


(1) Directorate-General for humanitarian aid - ECHO