Across Africa, the year 2025 has witnessed an alarming resurgence of cholera, with the Africa CDC reporting over 300,000 suspected cases and more than 7,000 deaths. This marks what the agency describes as the continent’s worst cholera outbreak in 25 years. The scale and severity of this outbreak raise urgent questions: Is the newly launched Continental Cholera Preparedness and Response Plan not only ambitious but effective?
At the heart of this crisis lie structural deficiencies that predate the outbreak: inadequate access to clean water, poor sanitation, and the compounding effects of conflict and displacement.
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Poor water infrastructure is not a peripheral issue; it is central. Africa CDC officials have pointed out that in countries such as Angola, nearly 44% of the population lacks access to safe drinking water, and only about 55% have adequate sanitation. In these conditions, cholera, a waterborne disease, finds ideal terrain to spread rapidly.
Conflict exacerbates the problem. In places like South Sudan, Sudan, and the Democratic Republic of Congo (DRC), years of instability have damaged health systems, disrupted water and sewage systems, and forced population displacements. Overcrowded camps, limited hygiene, and fragile infrastructure create a breeding ground for cholera. As Africa CDC Director-General Jean Kaseya has observed, “without water, we cannot really control the outbreak.”
These vulnerabilities are not merely local problems, but systemic and cross-border: when one country’s water system collapses, it can ripple outward, particularly in densely connected regions.
The Continental Framework: Aspirations and Mechanisms
In response to this mounting crisis, the African Union, in partnership with Africa CDC and WHO, unveiled a Continental Cholera Emergency Preparedness and Response Plan running from September 2025 to February 2026. The plan is structured around several key pillars: surveillance, case management, community engagement, logistics, and vaccination.
According to the plan’s own data, between 1 January and 27 July 2025, 213,586 suspected cholera cases were reported across 23 AU Member States, with 4,462 deaths, yielding a case fatality rate (CFR) of 2.10%. That figure is roughly double the emergency threshold of 1%, indicating that the outbreak is not only widespread but lethally efficient.
Furthermore, the plan acknowledges that four countries, Angola, South Sudan, Sudan, and DRC, account for 85% of the reported cases. These countries are caught in conflict or humanitarian crises, meaning that the response must be as much about rebuilding societies as it is about treating disease.
Ambitiously, the plan aims to reduce cholera deaths by 90% and to eliminate cholera as a public health threat in at least 20 African countries by 2030. This vision aligns with the broader “Global Roadmap to 2030,” which seeks cholera elimination through a combination of vaccination, water/sanitation investments, and effective outbreak response.
Evaluating Impact: Early Gains and Persistent Challenges
Despite the clear structure of the plan, translating ambition into impact is proving daunting. The rising death toll and sustained case numbers suggest that containment remains fragile. The case fatality rate of 2.10%, as reported in the plan, exceeds the acceptable emergency threshold, signalling that response systems may be overwhelmed or under-resourced.
Some countries are showing signs of stabilisation. The Africa CDC has flagged a decline in cholera cases in the Republic of Congo, and improvements in South Sudan and Somalia have also been reported. But this progress is uneven, reflecting the highly localised nature of cholera transmission, and the fact that not all nations have the same capacity or resources to deploy the continental plan with equal strength.
Logistical bottlenecks remain acute. Vaccine supply constraints, for instance, are a well-known global issue: there are shortages and unequal distribution, especially in low-resource settings. In the face of this, the continental plan’s reliance on rapid domestic resource mobilisation becomes even more critical. But so far, shifting from fundraising to sustained, in-country implementation is proving stretched. The plan needs not only emergency aid but long-term, predictable financing.
On the ground, efforts to engage communities are underway, but trust deficits persist, particularly in conflict-affected regions. Engaging displaced populations, rebuilding broken health systems, and scaling up water infrastructure demand more than short-term interventions; they require social cohesion, stability, and local buy-in.
The Role of International Partners
The African Union’s plan has catalysed support from international partners. At the launch in Lusaka, Zambia, AU leaders, WHO, and agencies like Gavi emphasised that cholera control is both a health and moral imperative. Gavi’s involvement is especially significant, as vaccines are central to outbreak control when water and sanitation cannot be improved overnight.
Further, the plan signals a shift toward domestic vaccine production, a cornerstone of Africa’s long-term self-reliance. This is consistent with broader continental goals under Agenda 2063, which envisions a self-sufficient Africa capable of producing its own medical technologies. However, producing vaccines locally remains a heavy lift, requiring regulatory capacity, manufacturing infrastructure, and rigorous quality assurance.
UN agencies and NGOs are also reinforcing ground operations. For example, in Darfur, a large-scale cholera vaccination campaign has been launched, backed by WHO, UNICEF, and Sudanese authorities, to reach nearly two million people in high-risk localities. Such operations underscore that the continental framework is acting not just as a plan on paper, but a call to action.
A Crossroads Moment: Is the Plan Enough?
From the evidence and data, the Continental Cholera Plan represents an urgent and well-structured response. It has galvanised political commitment, laid out measurable goals, and brought attention to underlying structural drivers. But whether it will carry the day depends on how well it confronts two deep-rooted realities.
First, the plan must contend with infrastructure deficits. Without serious investment in water, sanitation, and hygiene (WASH), especially in conflict zones, cholera will remain endemic. Vaccines can buy time, but they cannot substitute for clean infrastructure.
Second, political instability continues to shadow many of the hardest-hit countries. In contexts of war or displacement, emergency response is perilous, and rebuilding long-term systems is even harder. The success of the plan, therefore, is inseparable from broader governance, peace, and development challenges.
Yet, there is reason for cautious optimism. The continental plan has already brought together African leaders, regional institutions, and global health actors under a single blueprint. Its targets are bold but necessary. If implemented with fidelity, underpinned by funding, and reinforced by long-term infrastructure investments, the plan could become more than an emergency stopgap, it could be the foundation for a future Africa where cholera is no longer a recurring nightmare.
A Battle Not Yet Won, but a Framework Worth Fighting Around
Africa’s cholera crisis in 2025 is not simply a health emergency; it is a mirror to deeper systemic problems, from water insecurity to fragmented governance and chronic underinvestment in public infrastructure. The Continental Cholera Preparedness and Response Plan, launched by Africa CDC and the AU, offers a clear, continent-wide strategy to confront the outbreak.
But strategy alone is not enough. Success will depend on turning the plan’s pillars into tangible action: building WASH systems, ensuring vaccine delivery, restoring health services in conflict zones, and sustaining political will. The path ahead is neither simple nor short, but the plan provides a critical scaffold. Whether Africa rises to this moment will define not only its response to this outbreak but its capacity to prevent the next.
