Cholera, an illness caused by the bacterium Vibrio cholerae, continues to spread in regions where sanitation infrastructure has collapsed. The disease, which is transmitted through contaminated water, can cause severe dehydration and death within hours if left untreated. However, prompt medical intervention can save almost all affected individuals.
In 2024, global reports to the World Health Organization (WHO) indicated a rise in both cases and deaths from cholera. There were 560,823 reported cases and 6,028 deaths worldwide—a 5 percent increase in infections and a 50 percent increase in fatalities compared to the previous year. Sixty countries documented outbreaks, with Africa, the Middle East, and Asia accounting for 98 percent of cases.
The Eastern Mediterranean region has seen a significant resurgence of cholera. Although it is home to less than 10 percent of the world’s population, it now accounts for 74 percent of global cholera cases. Yemen was particularly affected in 2024, representing 89 percent of regional cases and 96 percent of deaths in the Middle East and Asia. Somalia and Sudan also experienced notable surges.
Sudan illustrates how conflict and climate change contribute to disease transmission. In Darfur alone this year, over 18,000 people were infected across all five states. Since mid-2024, more than 123,000 cases and nearly 3,500 deaths have been reported nationwide—the country’s longest outbreak on record. Ongoing war has destroyed hospitals and water systems; many people now rely on unsafe sources for drinking and washing. Flooding has further worsened contamination.
A large-scale oral cholera vaccination campaign was launched in Darfur in September 2024 despite logistical challenges. "Despite huge logistical barriers, the effort shows that when partners coordinate effectively, health action can succeed - even in conflict," according to officials involved with the campaign.
One quarter of cholera deaths now occur outside health facilities as patients die before reaching care. Climate factors such as floods and droughts are altering water systems while rapid urbanization creates crowded settlements prone to outbreaks.
Scientific progress has brought new tools: In early 2024 WHO prequalified Euvichol-S—a simplified oral cholera vaccine—which helped maintain stockpile levels above five million doses into mid-2025 despite ongoing shortages. However, demand remains high; only about two-thirds of requested doses were approved for emergency use this year.
Most affected countries are low-income or crisis-hit nations without local vaccine production capacity. Expanding regional manufacturing could help reduce reliance on limited global supplies.
Efforts have historically focused on reacting after outbreaks occur rather than preventing them through resilient systems. Experts say integrating cholera prevention into broader water sanitation programs (WASH), improving laboratory surveillance, and training health workers are necessary steps forward.
The WHO’s Global Roadmap to End Cholera by 2030 seeks a 90 percent reduction in deaths through coordinated national plans that connect disease control with climate adaptation and primary healthcare reforms.
Children under five remain especially vulnerable; they accounted for one-fifth of global cases last year due to high exposure risks and malnutrition—particularly acute in conflict zones like Yemen and Sudan.
Experts emphasize that "ending cholera is as much a political challenge as a scientific one." They note that prevention measures such as securing clean water are less costly than emergency responses but remain underfunded globally.
Local research institutions play an important role by expanding laboratory networks and using genomic surveillance for real-time tracking of outbreaks. Community-level efforts focusing on safe water storage practices and hand hygiene can also limit transmission when supported by effective communication campaigns.
Officials conclude that eliminating cholera would not only save lives but also restore confidence in public health institutions throughout crisis-affected regions: "Eliminating the disease would save lives, restore confidence in public health institutions and demonstrate that resilience can be built from the ground up."
