Cholera, a deadly yet preventable disease, continues to plague communities across Africa. Despite being easily treatable with rehydration and antibiotics, it remains a persistent public health threat. In the past four years alone, nearly 350,000 cases have been reported, with over 6,000 lives lost. Between 2014 and 2021, Africa accounted for 21% of global cholera cases and a staggering 80% of cholera-related deaths. This raises a critical question: why does a disease that can be controlled with clean water and basic medical care still wreak havoc on the continent?
Cholera is an acute diarrheal infection caused by ingesting food or water contaminated with the bacterium Vibrio cholerae. The disease can strike swiftly, with symptoms appearing within hours to days after exposure. Most infected individuals experience mild or no symptoms, but in severe cases, cholera can lead to profuse watery diarrhea, vomiting, and rapid dehydration. Without prompt treatment, a person can die within hours due to severe fluid loss.
The good news? Cholera is both preventable and treatable. Oral rehydration solution (ORS), intravenous fluids, and antibiotics can save lives when administered quickly. Yet, in many African regions, access to these basic interventions remains out of reach.
The persistence of cholera in Africa is not due to the complexity of the disease, but rather the conditions that allow it to spread. Several interconnected factors contribute to the ongoing outbreaks:
One of the primary drivers of cholera transmission is the lack of safe drinking water and proper sanitation. In many rural and urban slum areas, people rely on contaminated rivers, wells, or unprotected water sources. Open defecation and inadequate sewage systems further increase the risk of water contamination.
Even when cholera strikes, many health facilities lack the resources to respond effectively. Shortages of medical supplies, trained personnel, and treatment centers mean patients often arrive too late or are turned away. In some areas, clinics are too far from affected communities, delaying life-saving care.
Armed conflict and political instability displace millions, forcing people into overcrowded refugee camps with poor sanitation. These conditions are a breeding ground for cholera. Countries like the Democratic Republic of Congo, South Sudan, and Somalia have seen repeated outbreaks linked to displacement and humanitarian crises.
Flooding, droughts, and rising temperatures—exacerbated by climate change—can disrupt water systems and increase cholera risk. Floods wash sewage into drinking water sources, while droughts force people to use unsafe water. Seasonal outbreaks are common in many regions, especially during rainy seasons.
In some communities, fear and misinformation lead people to self-medicate or avoid health facilities altogether. Public health officials have warned that using unproven remedies or delaying treatment can be fatal. Education and community engagement are crucial to changing behaviors and encouraging early care-seeking.
The tools to end cholera already exist. The World Health Organization (WHO) and partners have promoted a three-pronged strategy:
Countries that have integrated these approaches—such as Zambia and Kenya—have seen significant reductions in cholera cases. However, sustained funding and political commitment are needed to scale up these efforts continent-wide.
Cholera should not be a death sentence in the 21st century. No one should die from a disease that can be treated with a simple rehydration solution. Ending cholera in Africa requires more than medical intervention—it demands justice, equity, and investment in basic human rights like clean water and healthcare.
As global citizens, we must support policies and programs that prioritize WASH infrastructure, strengthen health systems, and ensure vaccines reach those who need them most. With coordinated action, cholera can become a disease of the past—not a recurring crisis.
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