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In this paper the authors seek to identify the most appropriate model for a regional co-ordination mechanism for cholera preparedness, response and prevention. The qualitative mixed-method data collection approach that was followed revealed the need for alternative solutions, including a socio-political understanding of cholera responses at different levels of scale and at different stages of an outbreak. Important areas that need to be understood include the multiplicity of actors and the complexity of their interaction, the importance of building local capacity, the need for varying responses at different levels of scale, the need for improved inter- and intra-country co-ordination and information exchange, the importance of cultural belief systems and the impact of the media on the response to cholera outbreaks. Ultimately, despite the proposed co-ordinating role that the Southern African Development Community (SADC) can play in a regional cholera response effort, the onus remains on states to build capacity at the local level and to capacitate local communities to drive response efforts semi-autonomously. Keywords: Cholera prevention, preparedness and response, socio-political understanding of cholera, socio-cultural understanding of cholera, transboundary disease, Southern African Development Community (SADC), cholera

The case of cholera preparedness, response and prevention in the SADC region: A need for proactive and multi-level communication and co-ordination