Epidemic surveillance is necessary on a global scale. However, it is also suffering from the end of American funding for international solidarity. The WHO is facing drastic cuts in its funding. The WHO is the United Nations organization in charge, among other things, of epidemiological monitoring and the implementation – with NGOs and governments – of emergency responses to epidemic outbreaks (vaccination campaigns, follow-up of patients, etc.). By disrupting humanitarian work, this attack on epidemic surveillance has an impact primarily on people living in precarious conditions.
In the right place at the right time
Preventing epidemics is a major part of humanitarian work. Identifying areas at epidemic risk enables us to deploy our actions in relevant places. This is the case in Togo and Benin, where SOLIDARITÉS INTERNATIONAL teams have chosen to organize numerous hygiene awareness workshops.
Geographic targeting based on epidemic surveillance also enables action to be taken once an emergency has been declared. This was the case in January 2025, when the armed group M23 took control of the town of Goma, in the DRC, and forced the closure of the surrounding camps. Almost a million people were forced to return to their places of origin, as one of the country’s biggest cholera epidemics hit. Groups of people scattered into inaccessible mountainous areas, taking cholera with them. To locate them and bring them aid, SOLIDARITÉS INTERNATIONAL teams chose to follow the pockets of disease emergence in order to map out the water points to be rehabilitated and the actions to be implemented.
The importance of early warning
Living conditions and the environment are factors in the proliferation of many epidemics, making refugee and displaced persons camps particularly vulnerable. The widespread practice of open defecation and the lack of access to water and soap create an environment conducive to the spread of diarrhoeal diseases.
To ensure effective and appropriate action, health alerts need to be issued, and the various players involved need to coordinate their efforts. This has been the case for the past two years in the Chadian town of Adré, the entry point for 860,000 Sudanese fleeing the serious violence in their country. The construction of latrines in the camps and the installation of sanitation facilities help to slow down the proliferation of vectors such as flies and anticipate the spread of viruses such as cholera. Efforts to make water potable, such as chlorination, are being made, and good hygiene practices are being promoted.
All these measures are backed by constant epidemiological surveillance. Patients in health care facilities are tested, allowing us to sound the alarm if necessary. Black sludge must also be tested regularly in cases of acute diarrhoea, to identify the potential for vibrio cholerae and ensure safe treatment. If no tests are carried out, the disease will go undetected, and the sludge will not undergo the appropriate process.
In the humanitarian context, epidemics are yet another catastrophe that befalls people who are already victims of violence and misery. Ebola is raging in Uganda and threatening the Democratic Republic of Congo. In the Central African Republic, Bangui is suffering its first yellow fever epidemic. In Darfur, measles kills, etc… Malnutrition and lack of access to healthcare exacerbate the lethality of diseases such as Mpox, Lassa fever and measles. Preventing epidemics from emerging and spreading is a global challenge that cannot be abandoned. At a time when vaccination campaigns have already been cancelled as a result of reduced US funding, the question of epidemiological surveillance remains open.