London, UK – September 30, 2025

A concerning new report from the World Health Organization (WHO) highlights the continued and alarming intensity of the multi-country cholera outbreak, confirming a severe strain on global health resources. The crisis is compounded by the fact that the international oral cholera vaccine (OCV) stockpile has once again fallen to a critically low level, significantly undermining the ability of health agencies to mount an effective and timely emergency response.

The ongoing cholera upsurge, which has spanned multiple years, remains a Grade 3 emergency—the WHO’s highest classification. With conflict, climate change-related disasters, and mass displacement driving the spread, the fight against the disease is reaching a precarious phase as vaccine supply struggles to keep pace with demand.

The Global Spread: Hundreds of Thousands of Cases

The WHO’s latest external situation report indicates that from January 1 to the end of August 2025, a cumulative total of over 462,000 cholera and acute watery diarrhoea (AWD) cases and nearly 6,000 deaths have been reported globally.

The outbreak is highly geographically diverse, affecting 32 countries across five WHO regions, with the Eastern Mediterranean and African Regions bearing the brunt of the epidemic:

 * Eastern Mediterranean Region: This region has recorded the highest number of cases, with outbreaks in countries like Yemen, Afghanistan, and Sudan facing severe humanitarian challenges.

 * African Region: A large number of countries, including the Democratic Republic of the Congo (DRC), South Sudan, and Angola, continue to battle ongoing or resurgent outbreaks, with high Case Fatality Rates (CFR) in some areas indicating serious gaps in medical access and case management.

 * Resurgent Hotspots: The disease is resurging even in countries that have not reported substantial case numbers in years, further stretching the global response.

Stockpile Emergency: A Dire Shortage of Doses

The most alarming finding in the WHO report concerns the state of the global reserve of Oral Cholera Vaccine, the primary tool for rapid outbreak containment.

The emergency target for the global OCV stockpile is five million doses. However, the average stockpile level in August 2025 was reported to be just 2.6 million doses, falling dangerously short of the minimum safety buffer required to respond to multiple simultaneous outbreaks.

This shortage is a direct result of the immense and unprecedented global demand for the vaccine. The International Coordinating Group (ICG), which manages the stockpile, is forced to constantly approve vaccine distributions that far outstrip the available reserve, leading to a constant depletion even as manufacturers increase production. This situation has forced global health partners to maintain the temporary strategy of administering only a single dose of OCV in vaccination campaigns—a measure taken due to the scarcity, despite the standard protocol recommending a two-dose regimen for longer-lasting protection.

Headline Points on the Global Cholera Crisis

 * Cumulative Cases: Over 462,000 cholera/AWD cases and 5,869 deaths reported globally between January and August 2025.

 * Widespread Outbreak: Cholera is active in 32 countries across five WHO regions, confirming the epidemic’s multi-continental scope.

 * Stockpile Critical: The Oral Cholera Vaccine (OCV) stockpile is at an average of 2.6 million doses, critically below the 5 million dose emergency target.

 * Response Hindered: The shortage is crippling the ability of humanitarian agencies to deploy targeted, two-dose preventative campaigns and rapid-response vaccinations.

 * Drivers of Spread: Conflict, mass displacement, and climate change-related flooding are key factors intensifying the outbreaks, particularly in areas with poor water and sanitation infrastructure.

Global health leaders are urgently calling for increased investment in manufacturing capacity for the oral cholera vaccine and a significant scaling up of Water, Sanitation, and Hygiene (WASH) interventions—the long-term solution to curbing this ‘disease of poverty.’ Until then, the millions of people living in affected regions remain at heightened risk as the world struggles to keep pace with the spreading epidemic.