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The cholera outbreak in the WHO African Region in 2025 has affected 16 countries (Angola, Burundi, Comoros, the Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Malawi, Mozambique, Nigeria, South Sudan, Togo, the United Republic of Tanzania, Uganda, Zambia, and Zimbabwe). In February 2025, cases increased in Angola, the Democratic Republic of the Congo, Zambia, and Zimbabwe compared to the reported cases in January.

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 also hit on 13 January 2025, affecting Madagascar and Mozambique. 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 28 February was 39 535 and 746 respectively, with a case fatality ratio of 1.9%. The top five countries affected so far are South Sudan, the Democratic Republic of the Congo, Angola, the United Republic of Tanzania, and Ghana, which account for 93.2% (36 860) of the cases and 93.6% (698) deaths.

As of 28 February 2025, a cumulative total of 218 394 cholera cases, including 3 964 deaths (CFR: 1.8%), have been reported (Table 1) since 1 January 2024. The Democratic Republic of the Congo, Ethiopia, Nigeria, South Sudan, and Zimbabwe account for 68.5% (149 630) of all cumulative cases and 67.4% (2 673) deaths reported. Transmission is currently active in 15 countries.

The number of cases in February 2025 decreased compared to January 2025 by 9.0% from 20 711 cases to 18 847. Deaths in February 2025 increased compared to January by 4.7%, from 364 deaths to 381 (refer to Fig 2 - 4). The case fatality ratio (CFR) in January 2025 was 1.8% compared to 2.0% in February, which showed an increase in the CFR. Fourteen countries reported cases in January 2025, compared to 15 countries in February 2025.