ArticleFrontiers in public health2026
Rethinking cholera response: an orchestration framework for future preparedness in fragile conflict-affected settings, a case study from Sudan, 2025.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: The ongoing conflict in Sudan has intensified the country's already fragile public health landscape. Since July 2024, Sudan has faced one of the most extensive cholera outbreaks in its modern history, affecting 17 states and 109 localities and resulting in 83,245 reported cases and 2,124 deaths by June 2025. Traditional, hierarchical outbreak response systems have proven insufficient in such a dynamic, volatile environment. Methods: Using Sudan's 2024-2025 cholera outbreak as a case study, this paper proposes the Results: The model conceptualizes the Ministry of Health as a conductor leading an orchestra of diverse stakeholders. Each stakeholder represents an instrument section whose coordinated actions create a harmonized and adaptive response. Grounded in systems thinking theory, particularly the Iceberg and Biomatrix models, this framework identifies leverage points for governance, coordination, and resource optimization. Conclusion: The Orchestrated Symphony Model is proposed as a policy reform and practice improvement framework for cholera outbreak response generally and in conflict-affected settings particularly.
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