Extreme weather events have relentlessly hit parts of Africa over the past three years, with tropical storms, floods and droughts causing crises of hunger and displacement. They leave behind another deadly threat: some of the continent’s worst cholera outbreaks. In East Africa, more than 6,000 people have died and nearly 350,000 cases have been reported since the cholera outbreak began in late 2021.
Malawi and Zambia had the worst outbreaks on record. Zimbabwe had more waves. Mozambique, Kenya, Ethiopia and Somalia are also hard hit.
Everyone has experienced floods or drought — in some cases both — and health officials, scientists and aid agencies say the unprecedented rise in water-borne bacterial infection in Africa is the latest example of how extreme weather plays a role in triggering disease outbreaks.
“Epidemics are getting bigger because extreme climate events are more frequent,” said Tulio de Oliveira, a scientist based in South Africa who studies diseases in developing countries.
De Oliveira, who led the team that identified new variants of the coronavirus during the COVID-19 pandemic, said the latest outbreaks in southern Africa can be traced back to cyclones and floods that hit Malawi in late 2021 and early 2022, carrying the cholera bacteria. into areas where it usually does not reach.
In Zimbabwe and Zambia, the number of cases is rising as they battle severe droughts, with people in their desperation relying on less secure water sources such as boreholes, shallow wells and rivers, all of which can be contaminated.
Days after deadly floods in Kenya and other parts of East Africa this month, cases of cholera have emerged. The World Health Organization calls cholera a disease of poverty because it thrives where there is poor sanitation and a lack of clean water.
Africa has had eight times more deaths this year than the Middle East, the second worst-hit region.
In Epidemiologic week 13 of 2024, seven countries – Burundi, Comoros, Malawi, Mozambique, United Republic of Tanzania, Zambia, and Zimbabwe – reported a total of 1 345 new cases. Transmission is currently active in 13 countries. In 2024, Comoros confirmed an outbreak linked to cross-border transmission.
Since the beginning of the year 2024, the number of cholera cases and deaths reported to the WHO Regional Office for Africa (AFRO) as of 31 March was 62 175 and 1 232 deaths, respectively, with a case-fatality ratio of 2.0%. The Democratic Republic of the Congo, Ethiopia, Mozambique, Zambia, and Zimbabwe account for 94.6% (58 802) of the total cases and 95.7% (1 179) of total deaths this year.
As of 31 March 2024, a cumulative total of 348 609 cholera cases, including 6 342 deaths (CFR: 1.8%), have been reported since 1 January 2022. The Democratic Republic of the Congo, Ethiopia, Malawi, Mozambique, and Zimbabwe account for 73.6% (257 145) of the cumulative cases and 64.1% (4 065) of all cumulative deaths reported.
