In recent years, Africa has faced a significant resurgence of cholera, exacerbated by climate change and ongoing conflicts. The United Nations reports that in 2024 alone, over 175,000 cases and 2,700 deaths were recorded in Southern and Eastern Africa, marking the deadliest outbreak in a decade. Key factors include water scarcity, infrastructure challenges, recurrent flooding, and conflict. Despite efforts to improve water, sanitation, and hygiene (WASH) infrastructure, progress remains insufficient, with only 53% of the regional framework for cholera prevention and control implemented five years into the initiative.

The Impact of Cholera on African Communities

In the heart of a challenging season, several African nations have experienced a sharp rise in cholera cases. The Democratic Republic of the Congo (DRC), Ethiopia, Somalia, Zambia, and Zimbabwe have reported the highest numbers, driven by severe water shortages, damaged infrastructure, and frequent floods. According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), these conditions create a perfect storm for cholera outbreaks. This year, 14 countries have seen active cholera outbreaks, including new cases in Angola and resurgences in Uganda and Zambia.

Philippe Barboza, team lead of the World Health Organization’s (WHO) cholera program, highlights the interconnected challenges that perpetuate cholera's persistence. Insufficient WASH infrastructure, funding gaps, and weak health systems hinder long-term elimination efforts. Barboza emphasizes that cholera control is often neglected outside emergency responses, making sustained progress difficult. To address this, he recommends establishing an African Cholera Fund under the African Union and WHO-AFRO to finance sustainable initiatives.

Climate and Conflict: Catalysts for Cholera Spread

Climate change plays a critical role in worsening cholera outbreaks. Extreme weather events like floods contaminate water supplies, while conflicts force people into crowded camps with poor sanitation. Although climate change does not directly cause cholera, it significantly disrupts water sources and limits access to clean water. Ethiopia has made notable strides, implementing 76% of the cholera prevention framework, while other countries lag behind. Interventions such as hotspot mapping, surveillance, and rapid response capacity have shown promise, but progress in WASH infrastructure and sustainable funding remains slow.

Jackson Musembi, project manager at Amref Health Africa’s Global Health Security Programme, notes that only 31% of African countries have implemented water quality interventions, leaving millions vulnerable. Meanwhile, just 16% of countries have fully funded their National Cholera Plans, relying heavily on donor support. In Ghana, where only a quarter of households have exclusive-use toilet facilities, addressing poor sanitation and hygiene at the community level is crucial to breaking the cycle of cholera transmission.

To combat this crisis, experts advocate integrating cholera control into long-term programs for polio and malaria eradication. Expanding vaccination programs and supporting local vaccine production are also essential strategies. Ultimately, investment in WASH infrastructure is key to preventing future outbreaks and protecting vulnerable populations.

From a journalist's perspective, the resurgence of cholera in Africa underscores the urgent need for comprehensive, sustainable solutions. Addressing the root causes—climate change, conflict, and inadequate infrastructure—requires global collaboration and commitment. Only through coordinated efforts can we hope to eliminate cholera and safeguard public health in the region.