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The cholera outbreak in the WHO African Region in 2025 has affected 18 countries (Angola, Burundi, Comoros, the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Malawi, Mozambique, Namibia, Nigeria, South Africa, South Sudan, Togo, the United Republic of Tanzania, Uganda, Zambia, and Zimbabwe). Two countries (Namibia and South Africa) reported new imported cases without local transmission. In March 2025, cases increased in Angola, Burundi, the Democratic Republic of the Congo, Ethiopia, Mozambique, South Sudan, Uganda, and Zimbabwe compared to the reported cases in February.

In 2024, the El Nino phenomenon caused droughts in countries like Zambia and Zimbabwe and increased rainfall levels, causing floods and landslides in some communities of Kenya and Tanzania. The seasonality of cholera outbreaks continues to be an issue for countries to consider. In December, Tropical Cyclone Chido made landfall on the 15th, injuring several persons, causing infrastructure destruction, and significantly damaging the inadequate water, sanitation, and hygiene infrastructure in Comoros, Malawi, and Mozambique. Cyclone Dikeledi hit on 13 January 2025, affecting Madagascar and Mozambique. Furthermore, Cyclone Jude made landfall on 10 March 2025, affecting Nampula, Zambezia, Niassa, Tete, Manica, and Sofala provinces. Countries in the southern region will be impacted as the cyclone season has just begun. Meanwhile, Member States need to improve cholera preparedness and readiness, heightened surveillance, and scale up preventive and control measures in communities and around border crossings.

Since the beginning of 2025, the number of cholera cases and deaths reported to the WHO Regional Office for Africa (AFRO) as of 30 March was 67 496 and 1 398 respectively, with a case fatality ratio of 2.1%. The top five countries affected so far are South Sudan, the Democratic Republic of the Congo, Angola, Ethiopia and Ghana, which account for 89.4% (60 351) of the cases and 92.5% (1 293) deaths.

As of 30 March 2025, a cumulative total of 246 896 cholera cases, including 4 626 deaths (CFR: 1.9%), have been reported (Table 1) since 1 January 2024. The Democratic Republic of the Congo, Ethiopia, Nigeria, South Sudan, and Zimbabwe account for 69.0% (170 363) of all cumulative cases and 67.0% (3 101) deaths reported. Transmission is currently active in 17 countries.

The number of cases in March 2025 increased compared to February 2025 by 47.8% from 18 939 cases to 27 984. Deaths in March 2025 also increased compared to February 2025 by 67.7%, from 399 deaths to 669 (refer to Fig 2 - 4). The case fatality ratio (CFR) in February 2025 was 2.1% compared to 2.4% in March, which showed an increase in the CFR. Fifteen countries reported cases in February 2025, compared to 17 countries in March 2025.