By Joke Kujenya
AN ALARMING surge in cholera outbreaks globally has drawn attention to the severe impact of conflict, mass displacement, natural disasters, and climate change.
These factors have aggravated the spread of cholera in vulnerable regions, especially in rural and flood-affected areas with poor infrastructure and limited healthcare access.
From 1 January to 29 December 2024, 804,721 cholera cases and 5,805 deaths were reported across 33 countries in five WHO regions.
In December alone, 45,986 new cases were recorded in 21 countries, marking a 22% decrease from November.
However, the month also witnessed a troubling 8% rise in fatalities, with 457 deaths globally.
The Eastern Mediterranean Region reported the highest caseload and deaths, followed by the African Region and the South-East Asia Region.
The African Region recorded the most fatalities, with 345 deaths in December.
A significant development in 2024 was the introduction of a simplified oral cholera vaccine (OCV) production process, which boosted monthly output to 5.5 million doses.
This innovation raised the global emergency stockpile to 5.9 million doses in December, exceeding the five million doses required for immediate outbreak response.
However, despite increased production, global vaccine demand far outpaces supply, hampering efforts to control the outbreaks.
Cholera’s resurgence is closely linked to systemic challenges in affected regions.
In rural communities and flood-hit areas, inadequate water, sanitation, and hygiene infrastructure continue to delay treatment.
Cross-border factors complicate outbreak management, with displacement and conflicts exacerbating the crisis.
Zambia became the latest country to report outbreaks in December, adding to the global cholera burden.
Despite this, the total number of affected countries remained constant at 33.
The Eastern Mediterranean Region bore the highest burden, with over 597,000 cases reported throughout 2024. Meanwhile, the African Region followed with 177,570 cases, and the South-East Asia Region reported 19,348 cases.
WHO cautions that global cholera data may underrepresent the true burden of the disease due to reporting delays, underreporting, and varying surveillance methodologies across countries.
The disease’s global case fatality rate (CFR) remains challenging to evaluate accurately, given these disparities.
Efforts to mitigate cholera outbreaks must address systemic challenges, including strengthening healthcare access, improving water and sanitation systems, and ensuring equitable vaccine distribution.
Without immediate global intervention, cholera’s devastating toll is likely to persist, leaving millions at risk in 2025.
