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Cholera: A global call to action, May 2023

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Highlights

After years of steady decline, cholera has made a devastating comeback. A deadly combination of climate change, underinvestment in water, sanitation, and hygiene (WASH) services, and in some cases armed conflict, has put over 1.1 billion people at risk, with children under five particularly vulnerable. UNICEF has established a Global Cholera Emergency Cell to address the global cholera emergency. The Cell coordinates UNICEF’s response, leads coordination with partners and provides technical assistance to countries.

Overview of the situation

After years of steady decline, cholera has made a devastating comeback. A deadly combination of climate change, underinvestment in water, sanitation, and hygiene (WASH) services, and in some cases armed conflict, has put over 1.1 billion people at risk, with children under five particularly vulnerable.

In 2022, 30 countries faced cholera outbreaks – an alarming 145 per cent average increase from the previous five-year average. Countries like Lebanon and Syrian Arab Republic reported cholera for the first time in decades, while others like Haiti have experienced a resurgence after more than three years with no reported cholera cases. As of May 2023, at least 24 countries continue to report cholera cases, and outbreaks are spreading across borders, particularly in East and Southern Africa. Twenty-two additional countries around the world are at risk of declaring cholera outbreaks.

The current global cholera situation is unprecedented due to the alarming size of the outbreaks, geographic spread, and extraordinarily high case fatality ratio. Deadly outbreaks in Malawi and Nigeria had case fatality rates as high as 3 per cent, well above the acceptable 1 per cent. With most cholera deaths entirely preventable, mortality rates above 1 per cent usually signal problems with the quality, access and speed of treatment.