Climate change has been shown to play a major role in the spread of cholera outbreaks. Changing precipitation patterns and extreme weather events increase exposure risks, particularly in regions with fragile public health infrastructure. A recent review has explored the role of climate change in driving cholera transmission in Africa, with Sudan and Ethiopia serving as stark case studies (1).
At opposite ends of the precipitation spectrum, both droughts and floods create conditions for cholera to spread. Droughts force communities to rely on unsafe water sources, while heavy flooding overwhelms sanitation systems and increases human exposure to contaminated water, with both enabling transmission of waterborne diseases such as cholera. These climate-driven pressures compound existing vulnerabilities, including fragile health infrastructure, political instability, and limited access to clean water (1).
In Sudan, an outbreak declared in September 2023 resulted in over 8,000 suspected cholera cases and more than 200 deaths in only three months. Floods had displaced thousands, contaminated water supplies, and increased the risk of disease transmission. Ethiopia's Somali Region, by contrast, experienced a cholera outbreak during a prolonged drought. Nearly 800 confirmed cases and 23 deaths were reported within just two weeks, with children representing approximately 80% of cases. The drought in Ethiopia had led to greater reliance on unsafe water sources, accelerating cholera transmission. Droughts and floods caused by climate variability have also been linked to the spread of cholera in other African countries, including Malawi, Mozambique, Zimbabwe, Kenya, Somalia, the Democratic Republic of the Congo, Cameroon, and Nigeria (1).
The authors recommend a multi-pronged response that integrates climate adaptation with public health strategy. This includes deploying weather surveillance systems as early-warning tools for outbreaks, building flood-resistant water infrastructure, expanding strategic vaccination programs, and strengthening community engagement (1).
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1. Bekele BK, Uwishema O, Bisetegn LD, Moubarak A, Charline M, Sibomana P, et al. Cholera in Africa: A Climate Change Crisis. J Epidemiol Glob Health. 2025 Apr 30;15(1):68. doi:10.1007/s44197-025-00386-x
