Highlights

• From 27 April to 11 July 2017, 320 199 suspected cholera cases and 1 742 deaths (CFR: 0.5%) have been reported in 91.3% (21/23) of Yemen governorates, and 87.7% (292/333) of the districts.

Geographical distribution of cases

The five most affected governorates were Amanat Al Asimah, Al Hudaydah, Hajjah, Amran and Ibb with 54.7% (175 075/320 199) of the cases reported since 27 April 2017. Al Dhaele’e, Al Mahwit and Amran governorates had the highest attack rates (23.4‰, 21.6‰ and 21.3‰ respectively), and Raymah and Hajjah governorates the highest case fatality ratios (1.4% and 1.0% respectively) (see table).

Number of suspected cholera cases & deaths, AR and CFR by governorate, Yemen, 27 April – 11 July 2017

Highlights

• From 27 April to 12 July 2017, 326 082 suspected cholera cases and 1 743 deaths (CFR: 0.5%) have been reported in 91.3% (21/23) of Yemen governorates, and 87.7% (292/333) of the districts.

Highlights

• From 27 April to 13 July 2017, 332 658 suspected cholera cases and 1 759 deaths (CFR: 0.5%) have been reported in 91.3% (21/23) of Yemen governorates, and 87.7% (292/333) of the districts.

Highlights

• From 27 April to 15 July 2017, 344 751 suspected cholera cases and 1 784 deaths (CFR: 0.5%) have been reported in 91.3% (21/23) of Yemen governorates, and 87.7% (292/333) of the districts.

New York, USA
12 July 2017

Mr President, colleagues, former colleagues, distinguished representatives of the Security Council, thank you for this opportunity today to brief you on the health situation in Yemen where a cholera outbreak of unprecedented scale continues. This outbreak is being driven by conflict, the collapse of the basic public services and malnutrition.

Two years of conflict have devastated the lives of ordinary people and left nearly 15 million without access to basic health care. Almost the same number of people do not have regular access to clean water and sanitation. They have no choice but to drink dirty water, continuing the cycle of disease.

Cholera flourishes in a weakened health system. We are witnessing the second wave of an outbreak that first started in October 2016 and has led to more than 1700 deaths as has been indicated earlier by Mr O’Brien and more than 300 000 suspected cases in recent months. It has affected 21 of the 23 governorates and 286 of the 333 districts So the whole country is affected, almost. And the largest number of cases are in Amanat Al Asimah, in Al Hudaydah, Amran and also Ibb. Five of these governorates contribute 55% of the total cases of 300 000.

WHO, UNICEF and other partners are working with the Yemeni authorities to detect and track the spread of the disease and reach people with medical treatment, safe water and adequate sanitation and hygiene practices. WHO and UNICEF are supporting more than 600 cholera treatment centres and oral rehydration therapy corners in the most affected districts across the nation, and we plan to open another 500 centres.

In addition, rapid response teams have been trained and deployed. Emergency operation centres have been activated in Sana’a and priority governorates. More than 400 tonnes of critical life-saving supplies have been delivered, including IV fluid and treatment kits and more than 500 million people have been supported to access safe water.

At the same time, there is a shortage of doctors and nurses to help treat and care for those who are ill. Some have fled the country. Yet many continue to come to work, even though they have not been paid for more than ten months. WHO and UNICEF are paying incentives, travel costs, overtime and other allowances where and when they can to help to get them through this period but this is not a sustainable solution.

Other challenges include the fact that more than 55% of all health facilities are closed or only partially functional. There are no doctors in 49 of the 333 districts. The supply chain is hampered by restrictions on importations and logistics as well as a limited amount of implementing partners and funding.

The ongoing conflict makes these challenges worse because it is difficult to reach those in need. In light of this, we have four major requests of the Council today:

• First, accelerate the political process to bring an immediate end to this conflict so that people can not only survive but thrive.
  
• And second, in areas of continuing conflict ensure civilian infrastructure such as water and sanitation and health facilities are always protected in accordance with International Humanitarian Law.
  
• And third, donors need to not only quickly fulfill the pledges that they made at the highest level event on Yemen in April but also provide funds for this crisis in a more flexible manner. Ensuring health workers are paid and given incentives to remain at their posts is a critical issue. These brave professionals need our help so that they can continue to serve their communities.
  
• Lastly, provide political and financial support for long-term recovery and development. The partnership between the World Bank, UNICEF and WHO on revitalizing the health sector provides a useful model. We need to re-build the country health and sanitation systems, so that we can prevent and better contain future health risks.

And we have agreed with the World Bank, UNICEF and the World Food Programme to visit Yemen as soon as possible.

WHO, UNICEF and partners are doing all that we can to save lives and support the health system. But without peace there will be no end to the suffering of the people.

Highlights

• During week 28 (from 9 to 15 July 2017), 35 052 suspected cholera cases and 53 deaths were reported in Yemen.

• Since the beginning of the second wave of the outbreak (from 27 April to 16 July 2017), 351,045 suspected cholera cases, and 1 790 deaths (CFR: 0.5%) have been reported.

• Twenty-one of the country 23 governorates (91.3%) and 88.0% of the districts (293/333) have reported suspected cases since the start of the second wave.

• The overall decline of suspected cases reported in the last weekly (i.e. week 27) bulletin is confirmed. This decline is reflected in several of the most affected governorates (e.g. Amanat Al Asimah, Amran or Sana’a). The decline started from week 27 and continues in week 28, however the sharp decline in week 28 should be interpreted with caution given the remaining back log cases.

Highlights

From 27 April to 16 July 2017, 351,045 suspected cholera cases and 1,790 deaths (CFR: 0.5%) have been reported in 91.3% (21/23) of Yemen governorates, and 88% (293/333) of the districts.

Geographical distribution of cases

• The five most affected governorates were Amanat Al Asimah, Al Hudaydah, Hajjah, Amran and Ibb with 53.9% (189,375/351,045) of the cases reported since 27 April 2017.

• Al Dhaele’e, Al Mahwit and Amran governorates had the highest attack rates (26.1%, 25.3% and 23.6% respectively)

• Raymah ,Hajjah and Ibb governorates reported the highest case fatality ratios (1.3% ,0.9% and 0.9% respectively) (see table).

• The five most affected districts were Al Hali district (Al Hudaydah gov., 13,680 suspected cases and 23 deaths), Bani Al Harith (Amanat Al Asimah gov., 8,867 suspected cases and 10 deaths), Ma’ain (Amanat Al Asimah gov., 8,758 suspected cases and 7 deaths), As Sabain (Amanat Al Asimah gov., 6,854 suspected cases and 11 deaths), and Al Hawak (Al Hudaydah gov., 6,620 suspected cases and 11 deaths)

Highlights

From 27 April to 17 July 2017, 356,591 suspected cholera cases and 1,802 deaths (CFR: 0.5%) have been reported in 91.3% (21/23) of Yemen governorates, and 88% (293/333) of the districts.

Geographical distribution of cases

• The five most affected governorates were Amanat Al Asimah, Al Hudaydah, Hajjah, Amran and Ibb with 53.9% (192,488/356,591) of the cases reported since 27 April 2017. o Al Dhaele’e, Al Mahwit and Amran governorates had the highest attack rates (26.1‰,

25.8‰ and 24‰ respectively) o Raymah ,Hajjah and Ibb governorates reported the highest case fatality ratios (1.3% ,0.9% and 0.8% respectively) (see table).

• The five most affected districts were Al Hali district (Al Hudaydah gov., 13,820 suspected cases and 23 deaths), Ma’ain (Amanat Al Asimah gov., 8,939 suspected cases and 9 deaths), Bani Al Harith (Amanat Al Asimah gov., 8,890 suspected cases and 10 deaths), As Sabain (Amanat Al Asimah gov., 7,078 suspected cases and 11 deaths), and Al Hawak (Al Hudaydah gov., 6,784 suspected cases and 11 deaths)

HIGHLIGHTS

• In June 2017, the Ministry of Public Health and Population recorded 184 767 suspected cholera cases and 967 associated deaths (CFR- 0.52%).

• Since the beginning of the second wave on 27 April 2017, the cumulative number of suspected cases of cholera reported stands at 259 897 including 1 594 deaths with a case fatality rate of 0.6%. However, since October 2016, the cumulative number of suspected cases reported in Yemen is 291 554 including 1 678 deaths with a case fatality rate of 0.6%.

• The unprecedented surge of suspected cholera cases comes as the health system and civil infrastructure, including water and sanitation facilities in most Yemeni governorates is seriously affected by the ongoing conflict.

• Scaling up the multisectoral and coordinated response in affected districts and governorates is a crucial key to control the outbreak. Hundreds of cholera treatment centers and oral rehydration therapy points have been established and operationalized with support of health and WaSH partners.

Highlights

From 27 April to 18 July 2017, 362 545 suspected cholera cases and 1817 deaths (CFR: 0.5%) have been reported in 91.3% (21/23) of Yemen governorates, and 88% (293/333) of the districts.

Geographical distribution of cases

• The five most affected governorates were Amanat Al Asimah, Al Hudaydah, Hajjah, Amran and Ibb with 53.7% (194 835/362 545) of the cases reported since 27 April 2017.

  • Al Dhaele’e, Al Mahwit and Amran governorates had the highest attack rates (26.6‰, 26.3‰ and 24.4‰ respectively)
  • Raymah ,Hajjah and Ibb governorates reported the highest case fatality ratios (1.4% ,0.9% and 0.8% respectively) (see table).

• The five most affected districts were Al Hali district (Al Hudaydah gov., 14 055 suspected cases and 23 deaths), Ma’ain (Amanat Al Asimah gov., 9 024 suspected cases and 9 deaths), Bani Al Harith (Amanat Al Asimah gov., 8 981 suspected cases and 10 deaths), As Sabain (Amanat Al Asimah gov., 7 129 suspected cases and 11 deaths), and Al Hawak (Al Hudaydah gov., 6 841 suspected cases and 11 deaths).

Number of suspected cholera cases & deaths, AR and CFR by governorate, Yemen, 27 April – 18 July 2017

362 545
SUSPECTED CHOLERA CASES

659
LAB CONFIRMED CASES

1817
RELATED DEATHS

21
GOVERNORATES AFFECTED

HIGHLIGHTS

• National Emergency Operations Centres (EOCs) in Aden and Sana'a have now been redesigned and strengthened to harness the full capacity of United Nations agencies and partners to support the cholera response.

• The national Case Fatality Ratio (CFR) has been reduced to 0.5%, with 99.5% of people with suspected cholera surviving.

• Surveillance confirms a decline in suspected cases over the past two weeks in some of the most affected governorates (e.g. Amanat al-Asimah, Amran and Sana’a). This data should be interpreted with caution, however, given a backlog in the analysis of suspected cases. Even if the outbreak is beginning to slow in some areas, thousands are falling sick every day. Sustained efforts are required to stop the spread of this disease.

• The World Health Organization (WHO) has successfully established 47 diarrhoea treatment centres of the 50 centres in the original plan.

• A cholera vaccination campaign originally planned for July 2017 has been postponed at the request of the health authorities, in favour of a much larger preventive campaign next year targeting millions of Yemenis at risk of the disease.

• WHO and UNICEF are supporting a door to door awareness campaign at the end of July to help people understand how they can keep their families safe from cholera.

Situation update

Since the beginning of the second wave of the cholera outbreak on 27 April 2017, 362 545 suspected cholera cases and 1817 deaths have been reported. The number of affected governorates is now 21 (out of 23) and the number of affected districts is 292 (out of 333).

On a positive note, the nationwide case fatality ratio has been reduced to 0.5% – far below the target of less than 1%. This means that 99.5% of people with suspected cholera who access health services are surviving. In addition, surveillance confirms a decline in suspected cases over the past two weeks in some of the most affected governorates (e.g. Amanat al-Asimah, Amran and Sana’a). This data should be interpreted with caution, however, given a backlog in the analysis of suspected cases. WHO continues to monitor the situation to establish whether this downward trend continues over the coming weeks.

Even if the outbreak is beginning to slow in some areas, thousands are falling sick every day and the situation remains alarming. Yemen’s cholera outbreak is far from over. The rainy season has just started and may increase the pace of transmission. Sustained efforts are required to stop the spread of this disease.

Highlights

From 27 April to 19 July 2017, 368 207 suspected cholera cases and 1 828 deaths (CFR: 0.5%) have been reported in 91.3% (21/23) of Yemen governorates, and 88.6% (295/333) of the districts.

Geographical distribution of cases

• The five most affected governorates were Amanat Al Asimah, Al Hudaydah, Hajjah, Amran and Ibb with 53.8% (198 227/368 207) of the cases reported since 27 April 2017.

  • Al Dhaele’e, Al Mahwit and Amran governorates had the highest attack rates (27.2‰, 26.7‰ and 24.7‰ respectively)
  • Raymah ,Hajjah and Ibb governorates reported the highest case fatality ratios (CFR: 1.3%, 0.9% and 0.8% respectively).

• The five most affected districts were Al Hali district (Al Hudaydah governorate, 14 229 suspected cases and 23 deaths), Ma’ain (Amanat Al Asimah, 9 164 suspected cases and 10 deaths), Bani Al Harith (Amanat Al Asimah, 9 090 suspected cases and 10 deaths), As Sabain (Amanat Al Asimah, 7 215 suspected cases and 11 deaths), and Al Hawak (Al Hudaydah governorate, 6 907 suspected cases and 11 deaths)

Highlights

From 27 April to 22 July 2017, 384,719 suspected cholera cases and 1,858 deaths (CFR: 0.5%) have been reported in 91.3% (21/23) of Yemen governorates, and 88.6% (295/333) of the districts.

Geographical distribution of cases

The five most affected governorates were Amanat Al Asimah, Al Hudaydah, Hajjah, Amran and Ibb with 53.5% (205,933/384,719) of the cases reported since 27 April 2017.

 Al Dhaele’e, Al Mahwit and Amran governorates had the highest attack rates (28.7‰, 28.3‰ and 25.7‰ respectively)

 Raymah ,Hajjah and Ibb governorates reported the highest case fatality ratios (1.3% ,0.9% and 0.8% respectively)

Highlights

• During week 29 (from 16 to 22 July 2017), 34 253 suspected cholera cases and 44 deaths were reported in Yemen.

• Since the beginning of this outbreak second wave (from 27 April to 23 July 2017), 390,865 suspected cholera cases, and 1 864 deaths (CFR: 0.5%) have been reported in 21 of the country 23 governorates (91.0%), and in 88.6% of the districts (295/333).

• About 2% of the total population have been affected.

• The overall epidemic curve shows that the peak of this second wave was reached week 26 and the number of new suspected cholera cases is steadily declining.

362 545
SUSPECTED CHOLERA CASES

659
LAB CONFIRMED CASES

1817
RELATED DEATHS

21
GOVERNORATES AFFECTED

HIGHLIGHTS

• National Emergency Operations Centres (EOCs) in Aden and Sana'a have now been redesigned and strengthened to harness the full capacity of United Nations agencies and partners to support the cholera response.

• The national Case Fatality Ratio (CFR) has been reduced to 0.5%, with 99.5% of people with suspected cholera surviving.

• Surveillance confirms a decline in suspected cases over the past two weeks in some of the most affected governorates (e.g. Amanat al-Asimah, Amran and Sana’a). This data should be interpreted with caution, however, given a backlog in the analysis of suspected cases. Even if the outbreak is beginning to slow in some areas, thousands are falling sick every day. Sustained efforts are required to stop the spread of this disease.

• The World Health Organization (WHO) has successfully established 47 diarrhoea treatment centres of the 50 centres in the original plan.

• A cholera vaccination campaign originally planned for July 2017 has been postponed at the request of the health authorities, in favour of a much larger preventive campaign next year targeting millions of Yemenis at risk of the disease.

• WHO and UNICEF are supporting a door to door awareness campaign at the end of July to help people understand how they can keep their families safe from cholera.

Situation update

Since the beginning of the second wave of the cholera outbreak on 27 April 2017, 362 545 suspected cholera cases and 1817 deaths have been reported. The number of affected governorates is now 21 (out of 23) and the number of affected districts is 292 (out of 333).

On a positive note, the nationwide case fatality ratio has been reduced to 0.5% – far below the target of less than 1%. This means that 99.5% of people with suspected cholera who access health services are surviving. In addition, surveillance confirms a decline in suspected cases over the past two weeks in some of the most affected governorates (e.g. Amanat al-Asimah, Amran and Sana’a). This data should be interpreted with caution, however, given a backlog in the analysis of suspected cases. WHO continues to monitor the situation to establish whether this downward trend continues over the coming weeks.

Even if the outbreak is beginning to slow in some areas, thousands are falling sick every day and the situation remains alarming. Yemen’s cholera outbreak is far from over. The rainy season has just started and may increase the pace of transmission. Sustained efforts are required to stop the spread of this disease.