Data show a significant increase in annual cholera deaths

The World Health Organization (WHO) announced Global cholera statistics for 2023showing 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 4,000 people died last year from the preventable and easily treatable disease.

Forty-five countries reported cases, an increase from 44 the previous year and 35 in 2021. Thirty-eight percent of reported cases were among children under the age of five.

Cholera is an acute intestinal infection transmitted by contaminated food and water. Communities with limited access to sanitation are the most affected.

Conflict, climate change, inadequate safe water and sanitation, poverty, underdevelopment and population displacement due to re-emerging conflicts and disasters caused by natural disasters 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 countries in Africa have reported a high proportion of deaths in the community, indicating gaps in access to treatment.

This is the first year that multiple countries have reported cholera deaths that occurred outside health facilities, known as 'community deaths'. In five of the 13 reporting countries, more than 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 indicate 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 compared to the same period last year, 342,800 cases and 2,400 deaths have already been reported to WHO on all continents as of 22 August.

Increased demand for anti-cholera materials such as oral cholera vaccines (OCVs), diagnostic tests, and essential drugs such as oral rehydration salts and intravenous rehydration fluids will continue through 2023, challenging disease control efforts in global level. As of October 2022, the International Coordination Group (ICG), which manages emergency vaccine stocks, has suspended the standard two-dose vaccination regimen in cholera outbreak response campaigns, adopting instead a single-dose approach to reach and protect more people with given the limited accessories.

Despite low OCV supplies, a record 35 million doses were delivered last year, with the one-dose strategy in place. Although vaccination is an important tool, safe drinking water, sanitation and hygiene remain the only long-term and sustainable solutions to stop cholera outbreaks and prevent future outbreaks.

WHO considers the current global risk of cholera to be very high and is responding urgently to reduce the number of deaths and contain outbreaks in countries around the world. WHO continues to support countries through enhanced public health surveillance, case management and prevention measures; supply of basic medical supplies; coordination of field engagements with partners; and support for risk communication and community engagement.

From 2022, US$18 million has been allocated from the WHO emergency fund for the cholera response. WHO has requested US$50 million to respond to cholera outbreaks in 2024, but this need remains unmet.