The World Health Organization (WHO) has released global cholera statistics for 2023, showing an increase in the number of cases and deaths.
Reported cholera cases increased by 13% in 2023 compared to 2022, and deaths increased by 71%. More than 4,000 people died from the preventable and easily treatable disease last year.
Cases have been reported from 45 countries, up from 44 countries last year and 35 countries in 2021. Thirty-eight percent of the reported cases were in children under the age of five.
Cholera is an acute intestinal infection that spreads through contaminated food and water. Communities with limited access to sanitation are most affected.
Conflict, climate change, inadequate safe water and sanitation, poverty, underdevelopment and population displacement due to new or re-emerging conflicts and natural disasters all contributed to the increase in cholera outbreaks last year.
The geographic distribution of cholera changed significantly from 2022 to 2023, with a 32% decrease in reported cases from the Middle East and Asia and a 125% increase in Africa. Many African countries show high community mortality and disparities in access to treatment.
This year marks the first time that multiple countries have reported cholera deaths that occurred outside health facilities – so-called “community deaths”. In 5 of the 13 reporting countries, more than a third of cholera deaths occurred within the community, highlighting serious gaps in access to treatment and the need for a strengthened response in this sector.
Afghanistan, the Democratic Republic of the Congo, Malawi and Somalia continue to report large outbreaks with more than 10,000 suspected or confirmed cases, with Ethiopia, Haiti, Mozambique and Zimbabwe joining them in 2023.
Preliminary data indicates that the global cholera crisis will continue into 2024, with 22 countries currently reporting active outbreaks. Although the number of cases reported so far in 2024 is lower than the same period last year, as of August 22, 342,800 cases and 2,400 deaths have already been reported to WHO across all continents.
Increased demand for cholera supplies, including oral cholera vaccines (OCVs), diagnostic tests, and essential medicines such as oral rehydration salts and intravenous solutions for rehydration, will continue into 2023, challenging global disease control efforts. From October 2022, the International Coordination Group (ICG), which manages emergency vaccine supplies, is suspending the standard two-dose vaccination schedule for cholera outbreak response campaigns, adopting a one-dose approach instead to reach and protect more people with limited supplies.
Despite low OCV stockpiles, a one-dose strategy has been implemented, with a record 35 million doses shipped last year. While vaccination is an important tool, safe drinking water, sanitation and hygiene practices are the only long-term, sustainable solutions to end cholera epidemics and prevent future outbreaks.
WHO currently considers the global risk of cholera to be very high, and countries around the world are responding urgently to reduce the number of deaths and contain the outbreak. WHO continues to support countries through public health surveillance, case management, strengthening preventive measures, providing essential medical supplies, coordinating on the ground with partners, and supporting risk communication and community engagement.
$18 million has been provided by the WHO Emergency Response Fund for cholera response since 2022. WHO has requested $50 million to respond to the cholera outbreak in 2024, but this need remains unmet.