The World Health Organisation (WHO) has reported that Nigeria and six other countries are responsible for approximately 90% of global cholera cases and deaths. According to the organisation, 47 countries reported cholera cases and deaths in 2025. Although these figures represent surveillance data and may underestimate the actual global burden, they indicate a significant increase in cholera-related deaths. In 2025, cholera deaths rose by 30%, reaching 7,870, the highest annual death toll recorded since 1999.
The seven countries contributing to the high number of cholera cases and deaths are Angola, Bangladesh, Democratic Republic of the Congo, Nigeria, South Sudan, Sudan, and Yemen. The WHO African Region recorded the largest burden, with cases increasing by 34% and deaths rising by 58% compared to 2024. Dr. Chikwe Ihekweazu, WHO Executive Director of the Health Emergencies Programme, attributed the increase to inadequate access to safe water, sanitation, and hygiene. He emphasized the need for targeted investments in these areas to combat the rising trend of cholera cases and deaths.
Cholera is an acute diarrhoeal disease caused by Vibrio cholerae bacteria, which spreads through contaminated food and water, particularly in areas with inadequate sanitation. According to Dr. Ihekweazu, cholera remains preventable and treatable, but severe dehydration can become fatal if patients do not receive prompt treatment. In 2025, more than one in five reported cholera deaths occurred outside health facilities, while the fatality rate among patients treated in facilities remained below one percent globally.
Despite the challenges, Dr. Ihekweazu noted that global oral cholera vaccine production increased significantly, from about 30 million doses in 2022 to approximately 80 million annually in 2025. The International Coordinating Group approved 71 million vaccine doses for affected countries in 2025, including 20 million for preventive vaccination, which resumed after more than three years. This increase in vaccine production and distribution is expected to help combat the rising trend of cholera cases and deaths.
In addition to cholera, Dr. Ihekweazu reported on the progress made in controlling meningococcal disease. Twenty-four of 26 countries in Africa's meningitis belt reported 21,526 suspected cases and 971 deaths in 2025, representing a 4.5% fatality rate. Meningitis cases declined by 5.9% among countries reporting data for both 2024 and 2025, with vaccination contributing to progress against meningococcal disease. The introduction of the meningococcal A conjugate vaccine in 2010 led to a significant decline in serogroup A cases.
The WHO is also monitoring plague cases, which have been reported in 10 countries between 2019 and 2025. A total of 3,847 suspected plague cases and 423 deaths were reported, representing an 11% case fatality rate. Most cases were reported in Congo and Madagascar. Dr. Ihekweazu emphasized the importance of continued surveillance of rodents and other animal populations, as well as rapid outbreak response, to detect plague early and prevent wider transmission.
The WHO is working to strengthen surveillance, community engagement, vaccination, and access to quality healthcare to combat the rising trend of cholera cases and deaths. Dr. Ihekweazu stressed that a multi-faceted approach is necessary to address the root causes of cholera and other diseases. By investing in safe water, sanitation, and hygiene, and improving access to healthcare, it is possible to reverse the rising trend and prevent avoidable cholera deaths.
Key points
- Seven countries, including Nigeria, account for 90% of global cholera cases and deaths.
- Cholera deaths rose by 30% in 2025, reaching 7,870, the highest annual death toll recorded since 1999.
- Global oral cholera vaccine production increased from 30 million doses in 2022 to 80 million annually in 2025.
