According to the latest data from the Africa Centres for Disease Control and Prevention (Africa CDC), cholera has been surging across the continent since January 2025, with 206,789 cases and 4,330 deaths reported. The outbreak is affecting nearly half of the continent's countries, marking a sharp rise in both cases and geographical spread compared to 2024. The overall case fatality rate (CFR) stands at 2.1 percent, underscoring the deadly nature of the outbreak.
Founded in January 2016, the Africa CDC is a specialized technical institution of the African Union (AU). It was established to support the public health initiatives of AU member states and strengthen the capacity of their public health institutions to detect, prevent, control, and respond quickly and effectively to disease threats, particularly in health emergencies and disasters.
Currently, 23 AU member countries are experiencing active cholera outbreaks, up from 20 in 2024. According to the latest weekly report from the Africa CDC, around 254,000 cases were reported for the entire year in 2024. The mortality rate across Africa has also climbed to 2.1 percent, up from 1.9 percent in 2024.
This epidemic is the largest in recent years, affecting countries in West, Central, and East Africa, and putting a strain on fragile health systems that are already burdened by war, armed conflict, economic hardship, and climate-related shocks.
The conflict-torn countries of Sudan, the Democratic Republic of the Congo (DRC), and South Sudan have been particularly hard hit.
The current epicenters of the outbreak are in four countries that account for the vast majority of cases: South Sudan (67,064 cases and 1,142 deaths), DR Congo (40,487 cases and 1,102 deaths), Sudan (43,048 cases and 989 deaths), along with Angola (27,666 cases and 773 deaths).
As of August 2025, these nations together represent over 85 percent of all reported infections. The high number of cases in these countries reflects widespread transmission and severe challenges in accessing clean water, sanitation, hygiene, and healthcare.
Cholera spreads rapidly where sanitation is poor and clean water is scarce because it is caused by ingesting contaminated water or food. Many of the affected countries have experienced conflict, flooding, or drought, which damage infrastructure and displace populations into overcrowded camps with unsafe water supplies.
Beyond the epicenters, smaller but notable outbreaks have emerged in conflict-affected countries such as Ethiopia (5,755 cases and 49 deaths), Mozambique (4,167 cases and 43 deaths), Somalia (6,550 cases and 9 deaths), and Nigeria (2,124 cases and 68 deaths). Significant outbreaks have also emerged in Ghana (2,780 cases and 14 deaths) and Tanzania (3,892 cases and 40 deaths).
Ongoing conflict and large-scale forced displacement, notably in DR Congo and Sudan, increase exposure to contaminated water sources and impede access to adequate healthcare.
In DRC, the rapid spread of the disease is due to several factors, including contaminated water sources caused by flooding, a fragile healthcare system, limited access to sanitation and hygiene, as well as large-scale population movement, including the forced return of internally displaced people (IDPs) in eastern provinces.
On Friday, the UN Refugee Agency (UNHCR) reported a deadly cholera outbreak in a refugee settlement in eastern Chad housing Sudanese refugees from the Darfur region. The outbreak has raised concerns about deteriorating sanitary and health conditions amid a decline in humanitarian aid.
As of early August, 264 cholera cases and 12 deaths were reported in the Dougui refugee camp and the surrounding area. Suspected cases have also emerged in the Treguine settlement, which is one of many UNHCR camps in eastern Chad that host Sudanese refugees.
UNHCR’s Dossou Patrice Ahouansou, Principal Situation Coordinator for Eastern Chad, told journalists in Geneva that help to contain the disease needs to come immediately.
“We still have more than 230,000 refugees at the border in very difficult situation,” he said. “Without urgent action including enhancing access to medical treatment, to clean water, to sanitation, to hygiene and most important, relocation from the border, many more lives are on the line.”
As part of the response, the UN agency has suspended the relocation of refugees from border points to prevent new cases.
Border locations hosting a third of new refugee arrivals are at serious risk of transmission as more people continue to arrive from Darfur. In Adré, the largest spontaneous site hosting over 235,000 people, three suspected cases are currently under investigation, raising fears of wider spread.
Over 873,000 Sudanese refugees have fled Darfur and crossed into Chad, which is now hosting the largest number of registered Sudanese refugees since the war began in April 2023. One in three people in eastern Chad is now a refugee.
The situation is even more critical across the border in the Darfur region, where over 4,300 cases and 113 deaths have been reported.
On Friday, UN agencies said that urgent help is needed to halt the deadly cholera outbreak sweeping across Sudan while warning that communities continue to be terrorized by parties to the conflict, even as they flee violence.
Disease outbreaks are worsening and spreading. Fewer than 25 percent of health facilities in the most affected states are operational, and only 45 percent of facilities in other states are fully functional.
In addition to the intense fighting between the Sudanese Armed Forces and the paramilitary Rapid Support Forces, civilians are now facing a rapidly spreading and deadly cholera outbreak.
“Cholera has swept across Sudan with all the states reporting outbreaks,” said Ilham Nour, Senior Emergency Officer with the UN World Health Organization (WHO), noting that since July 2024 nearly 100,000 cases have been reported in the country.
Individuals can contract cholera through contaminated food or water. The bacteria can spread from one person to the drinking water supply or to water used to prepare or grow food. Communities with limited access to sanitation are most vulnerable because cholera can also spread when human feces containing the bacteria enter the water supply.
Symptoms of the disease include severe diarrhea, nausea, vomiting, increased thirst, leg cramps, and restlessness or irritability. Most people who are infected don't become ill, so these cases are never reported. Only about one in ten infected people develop the typical signs and symptoms of cholera, usually within a few days of infection.