The World Health Organization (WHO) has released its global cholera statistics for 2023, revealing a sharp increase in cases and fatalities. Reported cholera cases rose by 13%, while deaths surged by 71%, with over 4,000 fatalities recorded—a stark reminder of the severe impact of this preventable and treatable disease.
Cholera, an acute intestinal infection spread through contaminated food and water, disproportionately affects communities with poor sanitation. In 2023, 45 countries reported cholera cases, up from 44 in 2022 and 35 in 2021. Notably, 38% of these cases involved children under five years old.
The increase in outbreaks has been driven by a combination of factors, including conflict, climate change, inadequate access to clean water and sanitation, poverty, and population displacement due to conflicts and natural disasters. Geographically, the disease’s impact shifted significantly, with a 32% decrease in cases reported from the Middle East and Asia but a dramatic 125% increase in Africa. Many African countries reported a high number of community deaths, indicating severe gaps in access to treatment.
For the first time, multiple countries reported deaths occurring outside of health facilities—known as ‘community deaths.’ In five out of the 13 reporting countries, more than a third of cholera deaths occurred in the community, underscoring the urgent need to improve access to treatment and strengthen outbreak response efforts.
Major outbreaks were reported in Afghanistan, the Democratic Republic of the Congo, Malawi, and Somalia, with each country recording over 10,000 suspected or confirmed cases. Ethiopia, Haiti, Mozambique, and Zimbabwe also reported significant outbreaks in 2023.
Preliminary data indicate that the cholera crisis persists into 2024, with active outbreaks ongoing in 22 countries. Although the number of cases reported so far in 2024 is lower compared to the same period last year, 342,800 cases and 2,400 deaths have already been reported worldwide as of August 22.
The global demand for cholera-related materials, including oral cholera vaccines (OCV), diagnostic tests, and essential rehydration medications, continues to challenge disease control efforts. Due to limited vaccine supplies, the International Coordinating Group (ICG) managing emergency vaccines suspended the standard two-dose vaccination regimen in outbreak response campaigns since October 2022, opting for a single-dose approach to extend protection to more people. Despite the low vaccine stockpile, a record 35 million doses were distributed last year under the one-dose strategy.
While vaccination is a critical tool in the fight against cholera, the WHO emphasizes that safe drinking water, improved sanitation, and hygiene practices are the only sustainable long-term solutions to ending cholera outbreaks.
WHO has classified the current global cholera risk as very high and is actively working to reduce fatalities and control outbreaks through enhanced public health surveillance, case management, and prevention measures. The organization also provides essential medical supplies, coordinates field deployments with partners, and supports risk communication and community engagement efforts.
Since 2022, WHO has allocated US$ 18 million from its Contingency Fund for Emergencies towards cholera response efforts. However, WHO’s appeal for US$ 50 million to combat cholera outbreaks in 2024 remains unmet, highlighting the need for increased funding to support ongoing response initiatives globally.
