The World Health Organization (WHO) warns that the global cholera situation is worsening, with outbreaks intensifying in multiple countries.
This deterioration is largely driven by ongoing conflict, poverty, and fragile health systems.
Between January 1 and August 17 of 2025, the African WHO Region reported 172,750 cholera cases across 23 countries. Furthermore, 3,763 cholera-related deaths (case fatality rate, CFR: 2.2 %) were reported in the region, which indicates serious gaps in case management and delayed access to healthcare.
Countries such as the Democratic Republic of the Congo, South Sudan, and Sudan are experiencing large-scale cholera outbreaks that have persisted since 2024 or earlier. These three countries are experiencing high case counts and widespread transmission of the disease. Since the beginning of the year, the Democratic Republic of the Congo has reported 46,800 cases (CFR: 2.9%), South Sudan has reported 71,825 cases (CFR: 1.7%), and Sudan has reported 48,768 cases (CFR: 2.2%).
The disease is also resurging in several countries that had not experienced outbreaks in years, such as Chad and the Republic of the Congo. The spread into previously unaffected areas is hindering containment efforts and overwhelming fragile health systems, where limited prior exposure has led to low awareness of prevention and treatment measures, resulting in delayed detection of cases and care-seeking. As a result, these countries are experiencing extremely high fatality rates. In Chad, the first suspected case was reported on July 13 in Dougui Camp (in Chokoyane Health District, Ouaddaï Province), located approximately 50 km from the Sudan border. Between July 13 and August 19, the country reported 776 cholera cases, including 53 deaths (CFR: 6.8%). Strikingly, 27 deaths occurred in the community, highlighting critical gaps in timely access to healthcare. In the Republic of the Congo, the outbreak began in Brazzaville District and subsequently spread to districts along the Congo River. Between June 23 and August 17, 2025, the Republic of the Congo reported 457 suspected cholera cases and 35 deaths (CFR: 7.7 %).
Cholera transmission is driven by a widespread lack of clean water and sanitation.
Outbreaks are further exacerbated by conflict and the effects of climate change (e.g., drought and flooding). Such crises heighten the risk of cholera transmission by disrupting water and sanitation systems and forcing populations into overcrowded, unsanitary conditions. Insecurity and population displacement also obstruct surveillance and response activities. Frequent cross-border migration associated with trade, conflict, and displacement is also fueling cholera transmission across national borders, highlighting the urgent need for coordinated surveillance and response efforts.
Given the magnitude and severity of these outbreaks, the risk of cholera spreading both within countries and across national borders is considered very high. Effective cholera control requires a coordinated, multisectoral strategy that integrates robust surveillance, WASH interventions, timely case management, oral cholera vaccination, and active community engagement through social mobilization and risk communication. Without urgent public health interventions and international support, cholera transmission is likely to expand in the region.