Reported cholera deaths worldwide reached their highest level since 1999 last year, despite a fall in the number of reported cases, according to the World Health Organization.
Forty seven countries reported 451,499 cases and 7,870 deaths in 2025. Deaths were about 30% higher than in 2024, while reported cases fell by nearly 20%. WHO says these figures reflect reported surveillance data and are likely to underestimate the true global burden because many cases go unreported.
Africa Accounted for Most Reported Deaths
WHO’s African Region reported 245,501 cholera cases and 5,338 deaths in 2025, accounting for 54% of reported cases and 68% of reported deaths worldwide. Compared with 2024, the region recorded a 34% rise in cases and a 58% rise in deaths.
Seven countries accounted for around 90% of all reported cholera cases and deaths globally: Angola, Bangladesh, the Democratic Republic of the Congo, Nigeria, South Sudan, Sudan and Yemen.
Four of them Angola, the DRC, Nigeria and South Sudan were among the countries carrying much of the burden within WHO’s African Region. The concentration highlights where prevention, treatment and access to care remain especially urgent.
More Deaths Occurred Outside Health Facilities
More than one in five reported cholera deaths in 2025 occurred in the community rather than a health facility among countries that reported place of death.
WHO’s 2025 cholera report says 23 countries reported place-of-death data covering 72.9% of all reported deaths. Of those deaths, 22.7% occurred in the community. WHO said these deaths indicate that some patients died before reaching a health facility.
Cholera spreads through food or water contaminated with Vibrio cholerae. It can cause severe dehydration and can be fatal within hours without treatment, but prompt access to care can save lives.
Among patients treated in health facilities, the global fatality rate remained below 1%, although it exceeded that level in 12 countries in 2025.
The contrast between fewer reported cases and more deaths does not, by itself, establish a single cause. WHO cautions that surveillance quality and reporting vary between countries and that official figures do not capture every infection or death.
Vaccine Supply Improves, but Clean Water Remains Essential
Global production of oral cholera vaccines increased from about 30 million doses in 2022 to approximately 80 million in 2025.
The International Coordinating Group on Vaccine Provision approved 71 million doses for affected countries in 2025, including 20 million for preventive vaccination. Improved supply allowed preventive campaigns to resume in 2026 after being suspended for more than three years.
WHO continues to stress that vaccination is only one part of cholera control. Its recommendations also emphasise safe water, sanitation, surveillance, risk communication and rapid access to treatment.
What Happens Next
The latest figures show that reducing cholera deaths will depend not only on controlling transmission but also on ensuring that people can reach treatment quickly.
WHO says long term control requires sustained investment in clean water, sanitation, surveillance, vaccination and access to quality care, particularly in countries carrying the heaviest burden.
