Africa: Over 1 Billion in 43 Nations At Risk Amid Cholera Outbreaks, WHO Says

Cholera is an acute diarrhoeal infection caused by eating or drinking food or water that is contaminated with the bacterium Vibrio cholerae.
25 February 2023

A global surge of cholera cases has put one billion people in 43 countries at risk, the World Health Organization (WHO) cautioned this week.

Three countries, this week alone, have reported outbreaks, WHO cholera team leader Philippe Barboza told reporters at a press conference on Friday.

For the first time, WHO is asking donors for help to fight the outbreaks, he said.

Right now, 22 countries across the world are fighting outbreaks of the acute diarrhoeal infection caused by eating or drinking contaminated food or water. Cholera cases climbed in 2022, following years of falling numbers of cases, and the trend is expected to continue into this year, he said.

He said cases have been reported in five of the six regions where WHO operates. The latest WHO global overview published in early February showed the situation has further deteriorated since 2022.

Poverty, disasters, conflict and climate change consequences continue to be driving factors alongside a lack of access to safe water and sanitation, Dr. Barboza said.

Limited vaccine supplies

"An unprecedented situation requires an unprecedented response," he said, drawing attention to the limited availability of vaccines, medicines, and testing kits.

Only 37 million doses are available in 2023, he said. More doses are expected to be available by next year.

As a result of the current global surge, WHO is, for the first time ever, appealing to donors to support a $25 million fund to help to address cholera outbreaks and save lives, he said.

Prevention is key, he said, noting that nearly half of the world lacks access to safely managed sanitation.

"Access to safe drinking water and sanitation are internationally recognized human rights," he said. "Making these rights a reality will also end cholera."

Outbreak in Africa

An exponential rise in the number of cholera cases in Africa includes an outbreak in Mozambique, which is also grappling with severe storms brought on by cyclone Freddy. The first case of cholera in the current outbreak was reported to the Ministry of Health and WHO from Lago district in Niassa province in September.

As of 19 February, Mozambique reported a cumulative total of 5,237 suspected cases and 37 deaths. All six cholera-affected provinces are flood-prone areas, and WHO anticipates that more will be affected as the rainy season continues.

Considering the frequency of cross-border movement and the history of cross-border spread of cholera during this outbreak, WHO considers the risk of further disease spread as very high at national and regional levels.

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, WHO said. In 2022, nearly 80,000 cases and 1,863 deaths were recorded from 15 affected countries.

Multiple countries affected

Neighbouring Malawi is facing the deadliest cholera outbreakin two decades, and cases are being reported in other countries, including Ethiopia, Kenya and Somalia, WHO reported.

The UN health agency said challenges include climate change, which has led to drought or flooding in parts of Africa, resulting in increased population displacement and reduced access to clean water.

Worldwide, people in Haiti, India, Pakistan, the Philippines and Syria, among others, are also affected by outbreaks.

Global threat

Cholera remains a global threat to public health, WHO said. In 2017, affected countries, donors, and partners of the Global Task Force on Cholera Control launched a renewed global cholera control strategy, Ending Cholera: A Global Roadmap to 2030. It aims at reducing cholera deaths by 90 per cent over the next decade.

While the number of cases had been declining, WHO remains concerned about the current surge. Researchers estimate that every year, there are between 1.3 and 4 million cases and 21,000 to 143,000 deaths worldwide due to the infection.

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