Data from the WHO published in September 2023 offer an insight into the extent of cholera surges across the world. The comprehensive statistics for 2022 reveal that cases reported to WHO were “more than double” than those reported in 2021. The frequency and severity of outbreaks have increased, yet data remain “inadequate”.  

A 7th pandemic 

The report introduces 2022 as the year of a “7th cholera pandemic”, comparing the cases reported to WHO with those reported during the previous year. An area for concern is the change in geographical pattern of outbreaks, with countries that had not reported cholera in “many years” reporting outbreaks in 2022.  Notable details include: 

  • 472,697 cases were reported, compared with 223,370 in 2021 
  • 44 countries reported cases, an increase from 35 in 2021 
  • 7 countries reported outbreaks comprising over 10,000 suspected and confirmed cases 
What is driving this increase? 

WHO suggests that conflict, climate change, and “limited investment in development and population displacement due to emerging and re-emerging vulnerability” contributed to increased outbreaks. Furthermore, the end of COVID-19 restrictions, including a reduction in prevention and control measures and reduced outbreak response funding come into play.  

Cholera spreads through good and water contaminated with faecal matter that contains the Vibrio cholerae bacterium. Transmission is associated with a lack of adequate sanitation, often linked to “underdevelopment, poverty, and conflict”. The increased demand for cholera countermeasures has been “a challenge”, says WHO. In October 2022, the International Coordinating Group (ICG) suspended the standard two-dose vaccination regimen in outbreak response campaign, moving to a single-dose approach.  

The surge continues 

Unfortunately, data for 2023 so far suggest that the global increase is continuing; 24 countries are reporting active outbreaks, with some in the midst of “acute crises”. WHO continues to offer support to countries with activities in public health surveillance, health management, and prevention measures.  

WHO appealed for $160.4 million for the cholera response through the strategic preparedness, readiness, and response plan. So far $16.6 million has already been released from the WHO Contingency Fund for Emergencies.

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