The World Health Organization (WHO) has issued a strong warning about critical weaknesses in cholera surveillance, reporting, and response across several countries, including Nigeria. This concern comes amid a troubling surge in global cholera infections, with the African continent, once again, bearing the brunt of the crisis.

Between January 1 and May 25, 2025, Nigeria documented 1,562 suspected cholera cases, adding to the 117,346 infections reported across 17 countries within the WHO African Region. These numbers were obtained from WHO data provided exclusively to our correspondent on Friday.

Figures May Mask the Full Crisis

Despite the growing number of reported cases, WHO emphasized that the statistics may not accurately reflect the true scale of the outbreak. Underreporting, inconsistent data submission, and limited diagnostic capabilities across affected nations are contributing to unreliable surveillance, which undermines timely response efforts.

In its statement, the organization cautioned, “The data presented here should be interpreted cautiously due to potential underreporting and reporting delays. This may affect the timeliness of reports, and thus, the presented figures might not accurately represent the true burden of cholera.”

The agency further explained that due to the diversity of surveillance systems, differing case definitions, and inconsistent laboratory capacities between countries, comparing cholera data is highly challenging. “Even global case fatality rates need to be reviewed with prudence, as they are heavily influenced by variations in surveillance methodologies,” the statement added.

Cholera Cases and Deaths Continue to Rise Globally

According to WHO data, from the start of 2025 through May 25, a total of 211,678 cholera cases and 2,754 associated deaths were recorded across 26 countries spanning three WHO regions. The African Region recorded the most significant burden, followed by the Eastern Mediterranean and South-East Asia Regions.

In a sign of worsening conditions, WHO’s global epidemiological update for May 2025 revealed that the number of cholera and acute watery diarrhea cases rose by 35% in just one month. Nearly half of the 52,589 new global cases reported in May alone came from the African continent.

Nigeria’s WASH Infrastructure Remains a Major Vulnerability

Nigeria’s continued vulnerability to cholera outbreaks, particularly during the annual rainy season, is largely attributed to the country’s long-standing deficiencies in water, sanitation, and hygiene (WASH) infrastructure. Rural and conflict-ridden areas are disproportionately affected, with little to no access to clean water and proper waste disposal systems—conditions that create a fertile breeding ground for waterborne diseases like cholera.

Experts within Nigeria’s public health sector have repeatedly warned that without robust investments in preventive infrastructure and improvements in surveillance systems, the country could face an even more widespread outbreak, potentially resulting in hundreds of avoidable fatalities.

Dr. Halima Yusuf, a public health epidemiologist, stressed that “poor access to potable water, rampant open defecation, and overcrowded living conditions continue to expose millions to cholera risk. Without data accuracy, our response remains reactive instead of preventive.”

Cholera Vaccine Stockpiles Under Pressure

In an effort to contain the global spread, WHO highlighted the role of Oral Cholera Vaccines (OCVs) as part of the emergency response toolkit. However, it also raised concern over the pressure on global vaccine stockpiles.

By May 2025, the average stockpile of OCVs was 5.7 million doses, exceeding the emergency stockpile threshold of five million for the sixth consecutive month. While this indicates a buffer, WHO noted that high demand is continuously stretching supply, particularly as more countries request doses during emergencies.

Yet, vaccine deployment alone cannot replace the need for clean water access, community education, and early case detection.

Cholera Deaths in Africa Continue to Climb

WHO’s report shows that Africa recorded the highest number of cholera-related deaths this year, with 2,447 fatalities out of the global total. Nigeria has recorded 48 deaths, a figure that underscores the nation’s continuing struggle with timely detection, effective treatment, and adequate community-level education.

The agency called for urgent and increased investments into preventive efforts, early detection mechanisms, and better access to life-saving treatment, especially in the hardest-hit areas.

The Way Forward: WHO’s Recommendations

In light of the worsening situation, WHO is urging governments, donors, and health organizations to take the following critical steps:

1. Strengthen Surveillance Systems: Investment in digital data infrastructure, real-time reporting, and community-based surveillance mechanisms to enhance early detection.

2. Improve Access to Clean Water and Sanitation: Expansion of water infrastructure in underserved and high-risk regions, with targeted efforts in refugee camps, informal settlements, and conflict zones.

3. Expand Health Education Campaigns: Grassroots-level engagement to inform communities about hygiene practices, safe food preparation, and the importance of early medical intervention when symptoms occur.

4. Bolster Health Workforce Training: Equipping frontline health workers with the tools, knowledge, and resources needed to identify and manage cholera outbreaks efficiently.

5. Ensure Equitable Vaccine Distribution: Prioritizing OCV deployment to the most vulnerable regions while maintaining fair allocation across all affected countries.

A Looming Health Emergency?

As cholera continues to spread across fragile health systems, the situation may evolve into a large-scale public health emergency if not addressed swiftly. The convergence of poor infrastructure, erratic weather conditions, insecurity, and a lack of public health capacity creates a dangerous backdrop that could lead to further escalation.

In Nigeria’s case, unless structural changes are made—both in terms of short-term emergency response and long-term infrastructural investment—the country will remain on the frontlines of the global cholera crisis.

With just under half a year left in 2025, the trajectory of cholera outbreaks points toward worsening conditions if critical interventions are not urgently implemented.

WHO’s warning must not fall on deaf ears. It is a call to action—for Nigerian authorities and the global health community—to prevent what could otherwise become a preventable tragedy of massive proportions.