Cholera, the scourge of yore, is striking back — this time, it’s sweeping Southern Africa. Southern Africa began enduring its most terrible cholera outbreak in more than a decade in early 2024, leading health experts from the World Health Organization (WHO), Médecins Sans Frontières (MSF), and governments to label it a full-blown public health emergency.
Cholera is a diarrheal disease causedby contaminated water or food, normally in unsanitary conditions. Its symptoms include copious diarrhea, dehydration, and death in a matter of hours if not treated. Preventable with ease but treatable with clean water, intravenous fluids, and antibiotics, cholera erupts in the places where there is no infrastructure — and this is precisely transpiring in countries like Zambia, Zimbabwe, and Malawi.
The hardest hit, as of March, 2025, is Zambia. There are more than 21,000 confirmed cases, with close to 700 dead. The outbreak started in the country’s capital, Lusaka, in October,2023, but has since spread quickly throughout the country’s 10 provinces. The temporary cholera treatment camps are filled, with the IV fluids being given while the sick lie outside, lying in the grass. In many places, clean water is all but nonexistent, and basic hygiene items such as soap are a luxury.
The government has instituted emergency measures — school closures, limitations on social gatherings, and health advisories. The international relief community has come in with water purification tablets, latrine installation, and the establishment of mobile clinics. Yet the epidemic rages on. Flooding dueto record rains — very possibly exacerbated by global warming — has further contaminated water supplies and displaced populations, making the environment even more conducive to infection. No one knows if or when the epidemic may recede.
The regional nations are also in astate of vigil. Malawi has seen more than 2,000 cases, while Zimbabwe has declared a state of national disaster, with some districts reporting cases in excess. The cross border trade as well as movement fueled the regional outbreak, even exposing countries with better health infrastructures to the peril.
The response has also been hindered by shortages of vaccines. Oral cholera vaccination (OCV) is highly effective, but global supplies are limited. WHO, in collaboration with Gavi, the Vaccine Alliance, was forced in many locations to limit the standard two-dose regimen to a single dose in order to use the supplies to their fullest. To date in early 2025, over 5 million doses of vaccine have been consumed across Southern Africa — but this is a tiny proportion of the amounts needed.
The reappearance of cholera is a grim reminder that water borne diseases are just as a global threat today as they were centuries ago, especially in this era of climate change, urbanization, and structural inequality. This is not a regional crisis — it’s a wake-up call for the world to invest in sanitation,health education, and clean water infrastructure. Although cholera is altogether avoidable, this outbreak is a glimpse of what happens when the world’s health systems are under-resourced, inadequately trained, and beyond their breaking point. Southern Africa’s cholera epidemic can quickly become a larger, deadlier epidemic, one no border can contain, if not confronted by immediate, coordinated action.
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