Africa’s cholera crisis hits 25-year peak amid new surges

A catastrophic cholera outbreak in Africa has reached its highest level in a quarter-century, with severe new surges in Angola and Burundi signaling an escalating public health emergency.

According to the Africa Centres for Disease Control and Prevention (Africa CDC), the continent has recorded over 300,000 confirmed and suspected cases and more than 7,000 deaths in 2025, representing a 30% increase from the previous year. This escalating cholera crisis underscores the urgent need for improved water access and sanitation, as conflicts and climate-related displacement fuel the disease’s spread.

“A Major Issue” with a Rising Toll

The African Union’s public health agency released these stark figures on Thursday, highlighting a significant jump from 2024’s 254,075 infections. Africa CDC Director General Jean Kaseya conveyed the gravity of the situation during a news briefing.

“Cholera is still a major issue,” Kaseya stated. “It’s like every year we have more and more cases.”

The acute diarrheal disease, caused by the Vibrio cholerae bacterium, spreads through contaminated water or food. It does not transmit directly from person to person. However, it can cause severe dehydration and kill within hours if left untreated, posing a risk to even healthy individuals. Health experts attribute the current spike to a combination of contaminated water sources, poor sanitation, and mass displacement driven by ongoing conflicts and climate shocks.

Hotspots in Angola and Burundi

Kaseya identified Angola and Burundi as critical hotspots where renewed surges indicate intensely active transmission.

• Angola has reported at least 33,563 cases in 2025, resulting in 866 deaths.
• Burundi has recorded 2,380 cases and 10 fatalities.

These numbers reflect a broader pattern of resurgence across the continent, demanding immediate and coordinated action from local and international health bodies.

Root Causes: Water Scarcity, Conflict, and Displacement

The Africa CDC directly links the outbreak’s unprecedented severity to inadequate access to safe drinking water and sanitation facilities.

“As we know, without water, we cannot really control the outbreak,” Kaseya emphasized.

Conflicts across Africa have shattered civilian infrastructure, including sewage systems and water treatment plants. This forces populations into overcrowded displacement camps where hygiene standards collapse, and shared water sources become breeding grounds for the bacteria.

“Insecurity, displacement of our populations—all of that are not helping, in addition to a lack of WASH [Water, Sanitation, and Hygiene] commodities,” Kaseya added.

Sudan’s Perfect Storm

Nowhere is this crisis more evident than in Sudan, one of the hardest-hit nations. The country has recorded 71,728 cases and 2,012 deaths this year amid a devastating war.

The medical aid group Doctors Without Borders (MSF) described the situation as the country’s worst cholera outbreak in years.

“On top of an all-out war, people in Sudan are now experiencing the worst cholera outbreak the country has seen in years,” MSF stated in August.

In the Darfur region, MSF teams treated over 2,300 patients and noted 40 deaths in just one week. The outbreak echoes a 2017 epidemic that infected about 22,000 people and killed at least 700 in under two months.

Response and the Uphill Battle

Prevention remains the cornerstone of cholera control, but efforts face immense logistical hurdles. Vaccination campaigns, using effective oral cholera vaccines, are often difficult to implement in remote or conflict-ridden areas.

While international organizations like the World Health Organization (WHO) and UNICEF partner with local governments to distribute hygiene kits and promote safe practices, these measures are stopgaps. Long-term solutions require massive investment in resilient water and sanitation infrastructure.

However, funding shortages and political instability consistently slow progress. In Angola, urban slums with limited plumbing see high infection rates, while Burundi’s rural communities struggle with sparse access to healthcare.

A Call for Sustained Action

The international community has provided emergency aid, with support from the European Union and the United States. Yet, Kaseya warns that without addressing the root causes, cholera could become endemic in more regions.

“We must address the root causes,” he said, calling for collaborative and sustained action.

Compounding the problem, climate change introduces new risks. Increased flooding can contaminate water sources, while droughts can force people to use unsafe water, potentially worsening future outbreaks.

This 25-year peak in Africa’s cholera outbreak serves as a stark wake-up call. With surges from Angola to Sudan and Burundi, the continent needs urgent, coordinated investments in public health infrastructure. Prioritizing safe water, sanitation, and conflict resolution is essential to turn the tide against this preventable disease.