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The World Health Organization (WHO) has published global cholera statistics for 2023, showing an increase in cases and deaths.
The number of reported cholera cases increased by 13% and deaths by 71% in 2023 compared to 2022. Over 4000 people died last year from a disease that is preventable and easily treatable.
Forty-five countries reported cases, an increase from 44 the previous year and 35 in 2021. Thirty-eight per cent of the reported cases were among children under five years of age.
Cholera is an acute intestinal infection spread 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 emerging and re-emerging conflicts and disasters from natural hazards all contributed to the rise in cholera outbreaks last year.
The geographical distribution of cholera changed significantly from 2022 to 2023, with a 32% decrease in cases reported from the Middle East and Asia, and a 125% increase in Africa. Many countries in Africa reported a high proportion of community deaths, indicating gaps in access to treatment.
This is the first year that multiple countries have reported deaths from cholera which occurred outside of health facilities, known as ‘community deaths’. In five out of 13 reporting countries, over a third of cholera deaths occurred in the community, highlighting serious gaps in access to treatment and the need to strengthen this area of response.
Afghanistan, the Democratic Republic of the Congo, Malawi and Somalia continued to report large outbreaks of over 10 000 suspected or confirmed cases, with Ethiopia, Haiti, Mozambique and Zimbabwe adding to the tally in 2023.
Preliminary data show that the global cholera crisis continues into 2024, with 22 countries currently reporting active outbreaks. Although the number of cases reported so far in 2024 is lower compared to the same period last year, 342 800 cases and 2400 deaths have already been reported to WHO across all continents as of 22 August.
The increased demand for cholera materials such as oral cholera vaccines (OCV), diagnostic tests and essential medications like oral rehydration salts and intravenous fluids for rehydration persists into 2023, posing a challenge for disease control efforts globally. Since October 2022, the International Coordinating Group (ICG), which manages emergency vaccine supplies, has suspended the standard two-dose vaccination regimen in cholera outbreak response campaigns, adopting a single-dose approach instead in order to reach and protect more people given limited supplies.
Despite the low stockpile of OCV, a record 35 million doses were shipped last year, with the one-dose strategy in effect. While vaccination is an important tool, safe drinking water, sanitation and hygiene remain the only long-term and sustainable solutions to ending cholera outbreaks and preventing future ones.
WHO considers the current global risk from cholera as very high and is responding with urgency to reduce deaths and contain outbreaks in countries around the world. WHO continues to support countries through strengthened public health surveillance, case management, and prevention measures; provision of essential medical supplies; coordination of field deployments with partners; and support for risk communication and community engagement.
US$ 18 million has been released from the WHO Contingency Fund for Emergencies for cholera response since 2022. WHO has appealed for US$ 50 million to respond to cholera outbreaks in 2024, but this need remains unmet.
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Lusaka — African health ministers and partners are calling for increased investment in integrated health services to address the growing burden of severe noncommunicable diseases (NCDs), particularly those affecting women and underserved populations across the region. At a high-level side event during the Seventy-fifth session of the WHO Regional Committee for Africa, delegates emphasized the urgent need for equitable access to prevention, screening, treatment, and rehabilitation across the continuum of care for NCDs. Disparities are especially pronounced in rural areas, where health infrastructure and services remain inadequate. Breast and cervical cancers are among the leading causes of cancer-related deaths among women in sub-Saharan Africa—particularly cervical cancer, which is both preventable and treatable. It remains the most common cause of cancer death for women in the region. In 2022, Africa accounted for nearly a quarter (23%) of the 76 000 global cervical cancer deaths. Meanwhile, severe NCDs such as Type 1 diabetes, sickle cell disease, and heart conditions claim more than half a million lives annually, including among children, adolescents, and young adults in some of the continent’s poorest communities. Inequitable access to health services continues to hinder efforts to reduce this burden. To improve cervical and breast cancer care in the region, urgent investment is needed in leadership, governance, and financing. Strengthening these foundations is critical in the current funding landscape. Advancements in strategic planning, healthcare infrastructure, workforce training, and—most importantly—equitable access to screening, diagnostic, and treatment services are essential. To address these challenges, WHO and its partners showcased successful integrated models such as the Women’s Integrated Care for Cancer Services (WICS), the BEAT Breast Cancer Project, and the PEN-Plus Strategy. WICS strengthens early detection, treatment, and integration of women’s cancer services into primary health care systems in Côte d’Ivoire, Kenya, and Zimbabwe. The BEAT Breast Cancer Project is a transformative multi-year initiative aimed at reducing breast cancer mortality among women in Tanzania and Ghana through early detection, timely diagnosis, and comprehensive treatment access. “PEN-Plus, WICS and the BEAT Breast Cancer Initiative are models for a new standard of care, rooted in equity, access and health justice. I urge countries to prioritize policies that embed these models into broader health system strengthening, said Dr Mohamed Janabi, WHO Regional Director for Africa”. Côte d’Ivoire offers a compelling example of progress, combining high HPV vaccination coverage—reaching over three million girls (91.4%)—with WICS-supported community-based screening campaigns to strengthen cervical cancer prevention. In Kenya, cervical cancer screening has been successfully integrated into national health services. “This gathering marks a pivotal moment to accelerate action for breast cancer prevention in Africa. We deeply value the leadership of the Ministries of Health of Ghana and Tanzania, and the steadfast support of the Pfizer Foundation in helping us achieve this milestone. The side event builds momentum for the policy prioritization of women’s cancers, partnerships to strengthen the broader women’s cancer ecosystem, and advance a health-systems approach to breast cancer prevention and management”, said Dr Somesh Kumar, Senior Director, Jhpiego. PEN-Plus expands access to care for severe NCDs at the district hospital level. Since its implementation, 20 countries in Africa have increased access to services for severe NCDs. Over 15 000 people are currently receiving treatment for chronic conditions such as sickle cell disease and Type 1 diabetes through PEN-Plus clinics.
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