The study also calls for integrating cholera control into broader public health initiatives, expanding vaccination efforts, and investing in local vaccine production alongside improvements in WASH infrastructure.

In 2024, Southern and Eastern Africa reported over 175,000 cholera cases and 2,700 deaths, marking the deadliest outbreak in a decade, according to a UN brief released on February 17, 2025.

Out of 47 countries in the WHO African region, 29 are classified as cholera-endemic, but recent outbreaks have also affected non-endemic countries, highlighting systemic weaknesses in health infrastructure.

A recent study published in the BMJ Global Health journal reveals that only 53% of the World Health Organization's (WHO) cholera prevention framework, established for 2018-2030, has been implemented, significantly below the UN's target for elimination by 2030.

As of early 2025, 14 countries are experiencing active cholera outbreaks, with new cases reported in Angola and resurgences in Uganda and Zambia.

The Democratic Republic of the Congo, Ethiopia, Somalia, Zambia, and Zimbabwe have reported the highest cholera case numbers, driven by factors such as water scarcity, poor infrastructure, flooding, and ongoing conflicts.

Climate change is exacerbating the cholera crisis in Africa by causing extreme weather events that contaminate water supplies, while conflicts force populations into overcrowded and unsanitary living conditions.

Currently, only 31% of African countries have implemented water quality interventions, leaving millions vulnerable to unsafe water, and a mere 16% have fully funded their National Cholera Plans, heavily relying on donor support.

Ethiopia has made the most progress in implementing the cholera prevention framework, achieving 76%, while Mauritania and South Africa lag significantly behind at only 19%.

Philippe Barboza from WHO emphasizes that insufficient water, sanitation, and hygiene (WASH) infrastructure, along with funding gaps, are major obstacles to effective cholera control, which is often deprioritized outside of emergency situations.

To combat cholera effectively, the study advocates for the establishment of an African Cholera Fund under the African Union and WHO to secure sustainable financing for prevention initiatives.

Overall, chronic underfunding and inadequate infrastructure continue to impede cholera elimination efforts across the continent.