Cholera deaths surge by 50% globally as WHO warns of “very high” risk

Global cholera cases rose by 5% and deaths by nearly 50% in 2024 compared with the previous year, with more than 6,000 people losing their lives to a disease that is both preventable and treatable, according to new figures from the World Health Organization (WHO).

The report revealed that Africa’s case fatality ratio increased from 1.4% in 2023 to 1.9% in 2024, exposing critical weaknesses in health systems and access to life-saving care. One in four cholera deaths occurred outside health facilities, underscoring urgent gaps in community health services.

The WHO warned that the figures are likely underestimates of the true burden, pointing to conflict, climate change, population displacement, and poor access to safe water, sanitation, and hygiene as key drivers of the disease. Cholera, caused by the bacterium Vibrio cholerae, spreads rapidly through water contaminated with human waste.

In 2024, 60 countries reported outbreaks, up from 45 the previous year. Africa, the Middle East, and Asia accounted for 98% of all cases. Twelve countries each reported more than 10,000 infections, including seven experiencing major outbreaks for the first time. The disease also resurfaced in Comoros after more than 15 years, highlighting the persistent risk of re-emergence.

The WHO urged governments and donors to prioritise access to clean water, sanitation, and hygiene facilities, alongside stronger disease surveillance, rapid treatment, and vaccines. “These numbers are a stark reminder that cholera is not just a health crisis but a crisis of inequity,” the report noted.

Vaccine shortages remain a major obstacle. Although a new oral vaccine, Euvichol-S®, was added to the global stockpile in early 2024 — helping to keep reserves above five million doses for much of 2025 — supply has not met demand. Some 61 million doses were requested in 2024, but only 40 million were approved for use across 16 countries. As a result, health authorities have continued to rely on a temporary single-dose regimen, instead of the standard two-dose course.

Preliminary data show the crisis is persisting into 2025, with 31 countries already reporting cholera outbreaks this year. The WHO has classified the global risk from cholera as “very high” and says it is working with countries to strengthen surveillance, treatment, prevention, and community engagement.