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The cholera outbreak in the WHO African Region in 2025 has affected 14 countries (Angola, Burundi, Comoros, the Democratic Republic of the Congo, Ethiopia, Ghana, Malawi, Nigeria, South Sudan, Togo, United Republic of Tanzania, Uganda, Zambia and Zimbabwe). In January 2025, cases increased in the Democratic Republic of the Congo, Ethiopia, Nigeria, Togo, and Zambia compared to the reported cases in December 2024.

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 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 26 January was 20 117 and 336 respectively, with a case fatality ratio of 1.7%. The top five countries affected so far are South Sudan, the Democratic Republic of the Congo, United Republic of Tanzania, Angola and Ghana which account 92.7% (18 658) of the cases and 92.6% (311) deaths.

As of 26 January 2025, a cumulative total of 198 718 cholera cases, including 3 553 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 68.4% (135 941) of all cumulative cases and 68.1% (2 418) deaths reported. Transmission is currently active in 14 countries.

The number of cases in January 2025 decreased compared to January 2024 by 24.7% from 27 046 cases to 20 377. Similarly, deaths in January 2025 decreased compared to January 2024 by 49.0%, from 714 deaths to 364 (refer to Fig 2 - 4). The case fatality ratio (CFR) in January 2025 was 1.8% compared to 2.6% during the same month in 2024, which showed a reduction in the CFR. Despite more countries (14 countries) reporting cases in January 2025 compared to 13 countries in January 2024, the cases and the CFR were reduced.