GENEVA, Switzerland – The latest data released by the World Health Organization indicates a troubling rise in global cholera outbreaks, highlighting increased fatalities and cases worldwide in 2023. This uptick is signaling alarm among global health officials, as cholera, a preventable and treatable waterborne disease, claimed over 4,000 lives last year.
The WHO’s comprehensive overview shows a 13% spike in reported cholera cases and a stark 71% rise in deaths compared to the previous year. This disturbing trend was noted across 45 countries, marginally up from 44 in 2022, and significantly higher than the 35 nations reporting cases in 2021.
Cholera predominantly affects communities with poor sanitation and limited access to clean water, putting children at high risk. Remarkably, children under five accounted for 38% of the disease’s incidence worldwide.
Multiple factors have fueled the increase in outbreaks, including ongoing conflicts, climate variability, and insufficient clean water and sanitation infrastructure. These conditions exacerbate the public health challenge, particularly in underdeveloped regions, where poverty and displacement due to conflict or natural disasters further complicate efforts to control the disease.
A significant shift was observed in the geographical distribution of cases. The WHO report noted a substantial decrease of 32% in the Middle East and Asia, contrasted by a concerning 125% surge in Africa. Community deaths were notably high on the African continent, underscoring severe impediments to accessing healthcare.
For the first time, several nations reported a significant number of cholera fatalities occurring outside hospital settings, spotlighting the critical gaps in community healthcare provision. In some countries, more than a third of deaths were reported in community settings, making clear the urgent need for enhanced community-level responses and treatment access.
Countries like Afghanistan, the Democratic Republic of the Congo, Malawi, and Somalia have continued to experience severe outbreaks, with new significant outbreaks reported in 2023 in countries such as Ethiopia, Haiti, Mozambique, and Zimbabwe.
Looking ahead into 2024, preliminary figures suggest the crisis is far from over, with active outbreaks already reported in 22 countries. Despite a slight reduction in cases compared to the previous period in 2023, the numbers remain high, with nearly 343,000 cases and 2,400 deaths reported by late August.
Efforts to control the spread of cholera are hampered by a high demand for cholera control materials, including vaccines, diagnostic tests, and treatment supplies like hydration solutions. To manage limited resources, health authorities have adopted a single-dose vaccine strategy since October 2022, deviating from the traditional two-dose regimen to extend vaccine coverage.
Though vaccinations are crucial, sustainable solutions such as improving water quality, sanitation, and promoting hygiene are essential to eradicate cholera. Last year, despite the vaccine supply challenges, about 35 million doses were distributed globally under the single-dose protocol.
The WHO has characterized the global risk from cholera as “very high,” prompting a robust international response. The organization is bolstering efforts through improved surveillance, case management, and preventive measures, alongside coordinating necessary support such as medical supplies and field deployments.
To support these efforts, WHO has allocated $18 million from its Contingency Fund for Emergencies. However, it has identified a funding shortfall, citing a need for an additional $50 million to effectively address cholera outbreaks in 2024, underscoring the ongoing and urgent nature of the global response needed.