In Focus

Surge in cholera outbreaks puts 1 billion people at risk


The disease is once again on the rise, despite decades of progress against it

With 24 countries reporting cholera outbreaks since the beginning of 2023, the World Health Organisation has placed over one billion people directly at risk of cholera.

According to WHO, the global risk level is very high and this assessment is based on the increasing number of outbreaks and their geographic expansion, as well as a lack of vaccines and other resources necessary to combat the spread of the disease. 

The current number, size and concurrence of multiple outbreaks, the spread to areas free of cholera for years and the alarming high mortality rates present a major threat to global health security, the WHO added.

Since the middle of April 2023, further geographic spread in cholera outbreaks continues to be reported in the Horn of Africa, especially around the Mandera triangle, where borders of Ethiopia, Kenya and Somalia meet and population movement drives transmission across borders.

After decades of progress against cholera, cases are again on the rise, even in countries that had not seen the disease in years.

2022-2023 is seeing an unprecedented surge of cholera outbreaks across the world, including in countries  such as Lebanon, Syria, Pakistan or Haiti.which had not seen cholera cases in years and had invested in multisectoral control measures. 

As the climate emergency worsens, WHO fears human displacement will intensify, along with droughts and flooding – all conditions that give rise to cholera. “Unless we invest in systems that build preparedness and resilience among at-risk populations, the cholera burden will continue to rise,” WHO says.  

Cholera is an acute intestinal infection that spreads through food and water contaminated with the bacterium Vibrio cholerae. With safe water and sanitation, cholera can be prevented. It can kill within hours when not treated, but immediate access to treatment saves lives.

While the triggers for cholera outbreaks— such as poverty and conflict—are enduring, climate change and conflict are now compounding the problem. Extreme climate events like floods, cyclones and droughts reduce access to clean water and create an ideal environment for cholera to thrive.

In 2022, 30 countries reported cholera outbreaks, 50 percent more than the average in previous years. This trend continues into 2023. The recent outbreaks have also been more deadly, with case fatality rates being the highest recorded in over a decade.

The overall capacity to respond to the multiple and simultaneous outbreaks continues to be strained due to the global lack of resources, including shortages of the oral cholera vaccine, as well as overstretched public health and medical personnel, who are dealing with multiple disease outbreaks and other health emergencies at the same time.

WHO has urged the countries to invest in cholera control  measures that will contribute to the achievement of good health and wellbeing.

Also Read: Global cholera outbreak: WHO warns of ‘very high’ risk