HQ Team
September 4, 2024: Cholera cases rose 13% and deaths by 71% in 2023 compared to a year earlier as a shortage of oral vaccines continues and the global risk is “high,” according to a World Health Organization report.
More than 4,000 people died last year because of cholera, a disease that is “preventable and easily treatable,” the WHO stated in its Global Cholera Statistics 2023.
Forty-five countries reported cases, an increase from 44 the previous year and 35 in 2021. Thirty-eight percent 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.
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.
High proportion of community deaths
Many countries in Africa reported a high proportion of community deaths, indicating gaps in access to treatment, according to the WHO.
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 year 2023 was 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.
22 nations reporting active outbreaks
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 2,400 deaths have already been reported to WHO across all continents as of August 22.
The increased demand for 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, which manages emergency vaccine supplies, has suspended the standard two-dose vaccination regimen in cholera outbreak response campaigns, adopting a single-dose approach instead 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.
Sanitation, hygiene
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, according to the WHO report.
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.
The WHO has released $18 million from the WHO Contingency Fund for Emergencies for cholera response since 2022. WHO has appealed for $50 million to respond to cholera outbreaks in 2024, but this need remains unmet.
