Vibrio cholerae bacteria in the small intestine, 3D illustration. The bacterium causes cholera and is transmitted through contaminated water.
The World Health Organization (WHO) Regional Office for Africa in Brazzaville, Congo, reports that ten African countries have recorded an estimated 26,000 cholera cases and 660 deaths from the start of the year to 29 January 2023. Africa is experiencing an exponential rise in cholera cases amid a global surge. In the first month of 2023 alone, cases on the continent increased by more than 30 % compared with the total caseload for the entire year of 2022.
Cholera is an acute, highly virulent infection that can spread rapidly, causing severe dehydration, high morbidity, and mortality. The current outbreaks occur against a backdrop of extreme climatic events, conflicts, ongoing epidemics such as wild poliovirus, limited financial resources, and a strained health workforce still responding to the COVID‑19 pandemic.
In a press statement issued on Thursday, WHO noted that “an estimated 26,000 cases and 660 deaths have been reported as of 29 January 2023 in 10 African countries facing outbreaks since the beginning of the year.” In 2022, nearly 80,000 cases and 1,863 deaths were recorded across 15 affected countries. If the fast‑rising trend continues, the 2023 total could surpass the 2021 figures, which marked the worst cholera year in Africa in nearly a decade. The average case‑fatality ratio is now almost three percent, above the 2.3 % recorded in 2022 and far exceeding the acceptable level of below one percent.
The bulk of new cases and deaths have been reported in Malawi, which is experiencing its worst cholera outbreak in two decades. Neighboring Mozambique and Zambia have also recently reported cases. In East Africa, Ethiopia, Kenya, and Somalia are responding to outbreaks amid a prolonged, harsh drought that has left millions in dire need of humanitarian assistance. Burundi, Cameroon, the Democratic Republic of the Congo, and Nigeria have likewise reported cases.
According to the WHO Regional Director for Africa, conflict and extreme climatic events are worsening cholera triggers and increasing the toll on lives. “It’s critical for African countries to scale up readiness to quickly detect cases and mount a comprehensive and timely response. We are supporting governments to bolster key control measures to halt these outbreaks as quickly as possible,” she said.
So far this year, around 3.3 million cholera vaccine doses have been delivered to the Democratic Republic of the Congo, Kenya, and Mozambique (with additional deliveries expected in the coming days) through the International Coordinating Group on Vaccine Provision. This initiative, a partnership of the International Federation of the Red Cross and Red Crescent Societies, Médecins Sans Frontières, UNICEF, and WHO, manages emergency vaccine supplies. Because the global increase in cholera outbreaks has strained vaccine availability, the Coordinating Group has temporarily suspended the standard two‑dose regimen in outbreak response campaigns, opting for a single‑dose approach. A further surge in outbreaks could deepen the shortage.
“Every death due to cholera is preventable,” said Dr Moeti. “This disease is as much a health challenge as a development one. Investments in better sanitation and access to safe water strongly complement public‑health initiatives to sustainably control and end cholera.”
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