Researchers from the Johns Hopkins Center for Humanitarian Health have offered 20 recommendations to mitigate future cholera outbreaks in Yemen, where an epidemic that erupted in September 2016 resulted in more than 1 million suspected cases and some 2300 deaths over the next 22 months. Their report also serves as a guide for other regions where humanitarian crises develop.

Although the country had endured previous cholera outbreaks, it didn’t have a preparedness and response plan sufficient enough to overcome war-related challenges in coordination, logistics, security, and access to treatment.