Artificial Intelligence Distributionally Robust Optimisation of Cholera Rehydration Fluid Allocation Under Variable Oral Rehydration Salt Production Capacity: A computed Healthcare Shortage Equity Evaluation

Cholera outbreaks create acute shortages of oral rehydration salts (ORS), and allocation rules that ignore production variability can systematically disadvantage the districts with the least buffer stock. the present analysis formulates ORS allocation as a distributionally robust optimisation problem in which the ambiguity set is defined over production shortfalls, and it evaluates the equity consequences of that formulation against a deterministic nominal model and a worst-case robust model. The evaluation is a replication study: no field data are used, and the operating characteristics of the allocation rules are characterised across a declared design grid of 8, 16, 24 and 32 districts and effect sizes of 3, 5 and 8 percentage points, with 2000 replications per cell. The between-district standard deviation is 6.0, the residual standard deviation is 4.5, and the intraclass correlation is 0.64. The distributionally robust rule reduces the maximum district-level coverage shortfall relative to the nominal rule at every effect size, and it does so without the coverage collapse that the worst-case rule produces when production is near its expected value. The contribution is a formalisation of shortage equity as a distributionally robust criterion and a demonstration that the equity gain is bounded by the ambiguity radius rather than by the nominal production forecast.