Scale-up cholera outbreak response in priority districts The Project covers  three immediate needs:
1. Avoid the disruption (functional and operational)of the existing 73 DTCs and 28 ORCs directly supported by WHO. As the levels of poverty have increased and civil servants do not receive regular salary, it is critical to retain the healthcare workers assigned to the cholera outbreak response. Incentive payments remain an essential part of the response – they contribute to maintain facilities open and running there cannot be any response without dedicated and well-trained health care workforce.
2. Expand and scale-up the number of DTCs and ORCs using the Health Cluster DTCs and ORCs gap analysis as well as the weekly EPI curve data since this source provides real-time information on the needs in terms of demand. 
3. Procure and distribute cholera kits to ensure access to safe treatment of the cholera cases. Linked to this, WHO will distribute newly designed kits for the District Rapid Response Teams (RRT kits). 
The RRT kit is an entirely new concept to equip RRTs to be better prepared when responding to alerts, incidents and events in the field. The idea is that each RRT kit contain case investigation forms, outbreak investigation forms, stationeries, basic medicines, infection prevention and control materials, Aquatabs, and oral rehydration salts. These materials are intended not only to investigate suspected cholera cases for epidemiological purposes but also to trigger necessary action as quickly as possible. The composition of the kits is here annexed. 
During the last week of consultation with the Health Cluster and national counterparts, it was agreed that in the next 6 months WHO will contribute to the scale-up of the cholera outbreak response by taking the following actions: 
1 .Activate additional 69 DTCs( 52 DTC activation will be supported with this grant) and 26 ORCs(all of them will be supported with this grant), opening DTCs  and ORCs  in districts currently  featuring gaps in terms of access. This was decided based on the HC gap analysis of DTCs and ORCs. To date, the Health Cluster target is to have 194 DTCs and 304 ORCs in place at earliest. Out of 194 DTCs, WHO will directly run /support 144 DTCs (74% of the total number of DTCs). 
Out of the 304 ORCs, WHO will directly run/support 54 ORCs (18% of the total number of ORCs).  The activation of new DTCs and ORCs will be sequenced and take place in the next 3-4 weekgeographic distribution of the existing health facilities where the DTCs and ORCs shall be activated availability of funds (priority one locations will be addressed first).WHO will provide CSSW with additional financing for the cholera response ensuring the following to support 5 DTCs and 8 ORCs in Taizz, Aden and Al Jawf governorates. The list of locations where WHO will activate additional DTCs and ORCs is here annexed. 
2. Concentrate the response on DTCs since DTCs receive the most critical cholera patients in need of life-saving treatment these patients are those who need to be hospitalized. From an operational and technical point of view, establishing and running DTCs requires additional medical and operational support as compared to ORCs.  
Based on consultations with other HC partners, and building on what we learnt from 2017-18 response, other partners opt to run ORCs since ORCs require less resources (medical staff, logistics, administration of treatment). The selection of DTCs/ORCs is based on rapidly increasing incidence (newly occurring cholera cases) in the priority districts where these DTCs/ORCs are located. In coordination with the Health and WASH Cluster partners, WHO will focus on actions to limit nosocomial transmission and improved patient-management protocols, including those related to the treatment of SAM children admitted at the DTCs.
3. Train and re-train the staff of all 194 DTCs and support the monitoring of the case management for all 194 DTCs regardless of the single organizations running the DTCs.