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The cholera outbreak in the WHO African Region in 2024 has affected 18 countries (Burundi, Cameroon, Comoros, Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Malawi, Mozambique, Niger, Nigeria, South Africa, South Sudan, Togo, United Republic of Tanzania, Uganda, Zambia and Zimbabwe). In December 2024, cases increased in Burundi, the Democratic Republic of the Congo, Ghana, Malawi, South Sudan, and Zimbabwe.

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. Countries in the southern region will be impacted as the cyclone season just began. 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 2024, the number of cholera cases and deaths reported to the WHO Regional Office for Africa (AFRO) as of 31 December was 169 801 and  3 056 respectively, with a case fatality ratio of 1.8%. The Democratic Republic of the Congo (DRC), Ethiopia, Nigeria, Zambia, and Zimbabwe account for 69.0% (117 199) of the total cases and 79.1% (2 417) of total deaths reported this year.

In December 2024, eleven countries – Burundi, the Democratic Republic of the Congo,  Ghana, Malawi, Mozambique, Nigeria, Togo, South Sudan, the United Republic of Tanzania, Zambia, and Zimbabwe – reported a total of 18 108 new cases and 243 deaths (CFR = 1.3%).

As of 31 December 2024, a cumulative total of 457 129 cholera cases, including 8 181 deaths (CFR: 1.8%), have been reported (Table 1) since 1 January 2022. The Democratic Republic of the Congo, Ethiopia, Malawi, Mozambique, and Nigeria account for 69.1% (315 784) of all cumulative cases and 65.3%     (5 337) deaths reported. Transmission is currently active in 11 countries.

The number of cases in 2024 has decreased compared to 2023. From January to December, the cases decreased by 12.0%, from about 192 919 in 2023 to 169 800 in 2024 (refer to Fig 2 - 4). However, there was an increase (3.1%) in the number of deaths, with about   2 964 deaths in 2023 and 3 055 in 2024 (see Fig 4). This was due to a large number of deaths reported from the Southern subregion, mainly from Zambia and Zimbabwe and recently in the United Republic of Tanzania and South Sudan (due to the outbreak in Sudan and migration across the border). However, the number of deaths reported in 2024 was lower than in 2023 from epi weeks 5-11, 17-23 before an increase in epi week 24 (refer to Fig 4). The average case fatality ratio from January to December was 1.5% in 2023 compared to 1.8% in 2024.