Cholera continues to spread where water, sanitation and health systems are weak. In 2024 the World Health Organization reported 560,823 cases and 6,028 deaths; infections rose by 5 per cent and deaths rose by 50 per cent from the previous year. Sixty countries recorded cases, and Africa, the Middle East and Asia bore 98 per cent of the global burden.
The Eastern Mediterranean region was disproportionately affected: it has under 10 per cent of the world population but accounted for 74 per cent of global cases. Yemen alone constituted 89 per cent of cases and 96 per cent of deaths in the Middle East and Asia in 2024. Sudan’s outbreak since mid-2024 has produced over 123,000 cases and 3,494 deaths, with Darfur seeing infections of more than 18,000 people. In September a large oral vaccination campaign in Darfur protected 1.6 million people despite major barriers.
There have been scientific advances: WHO prequalified a simplified oral vaccine, Euvichol-S, in early 2024 and the global stockpile stayed above five million doses in the first half of 2025. Still, demand outpaces supply: in 2025, 65 million doses were requested but only 45 million were approved for emergency use. Most programmes use a single-dose regimen that gives shorter protection but allows wider coverage, while production remains concentrated outside the most affected countries.
The WHO calls for a shift from reactive response to resilient prevention through its Global Roadmap to End Cholera by 2030, which aims to cut deaths by 90 per cent. Priority measures include stronger water and sanitation (WASH), better laboratory surveillance and rapid diagnostics, training of health workers, expanded regional vaccine manufacturing, and improved child vaccination and nutrition.
- Regional collaboration on early-warning systems and pooled emergency stockpiles
- Local laboratory networks, genomic surveillance and rapid tests
- Community measures: safe water storage, hand hygiene and early care-seeking
Difficult words
- sanitation — systems for clean water and waste removal
- burden — a heavy problem or cost for society
- prequalify — to officially approve a product for useprequalified
- outpace — to increase or grow faster than somethingoutpaces
- regimen — a fixed schedule of medical treatment
- surveillance — continuous observation to detect disease spread
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- What are the advantages and disadvantages of using a single-dose vaccine strategy in outbreaks? Give reasons from the article.
- How could expanded regional vaccine manufacturing help the most affected countries? Give two possible effects.
- Which priority measures listed in the article would be most important for your community and why?
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