In collaboration with health and WASH partners, the World Health Organization (WHO) and the Government of Bangladesh conducted a multisectoral tabletop simulation exercise on 6 May 2025 in Cox’s Bazar to assess and enhance cholera preparedness and response in Rohingya camps and host communities.

The exercise convened frontline professionals, including health managers, epidemiologists, medical coordinators, and Water, Sanitation, and Hygiene (WASH) experts, to assess the Acute Watery Diarrhoea/Cholera Preparedness and Response Plan, identify operational gaps, and strengthen intersectoral coordination. The simulation also integrated the 2024/25 Cholera Action Plan and the Joint Assessment and Response Team (JART) components to ensure alignment with global standards.

The urgency of this exercise was underscored by the most recent and severe cholera outbreak in the camps, which occurred between June 2024 and January 2025, resulting in 581 confirmed cases, and nearly 40% of which were in children under five. While rapid interventions, including enhanced surveillance, use of rapid diagnostic tests (RDTs), laboratory confirmation, case management, Risk Communication and Community Engagement (RCCE), water treatment, hygiene promotion, and a reactive Oral Cholera Vaccination (OCV) campaign, were instrumental in containing the outbreak, several critical gaps were identified. These included inconsistent water chlorination, inadequate sanitation, insufficient screening of new arrivals, limited community engagement, weak coordination between WASH and Health sectors, and inconsistent sharing of water quality surveillance data. “This exercise reinforced the complementary role of WASH in preventing and containing cholera outbreaks,” said Shejeda Begum, UNICEF’s WASH Officer in Cox’s Bazar. “It allowed us to revisit coordination protocols, clarify roles, and apply practical solutions to real-world challenges.”