Preventable cholera deaths rise in Horn of Africa's longest outbreak
Nairobi, 4 September 2026
Despite a 99 per cent recovery rate with prompt treatment, cholera deaths are rising across the Horn of Africa during the region’s longest-recorded, climate-threatened outbreak.
A funding deficit exacerbates the crisis
The prolonged cholera crisis across the Horn of Africa is unfolding against a backdrop of severe funding shortages. In May 2023, international donors pledged USD 2.4 billion of the required USD 7 billion for vital humanitarian assistance in the region [1]. This means only 34.286 per cent of the necessary funding was met, leaving a substantial gap of 4.6 billion USD to address critical needs. According to Médecins Sans Frontières (MSF), this lack of resources has directly impacted the capacity to manage outbreaks, which have been spreading through camps such as Dadaab in Kenya since November 2022 [1]. In places like the Kordofan region of Sudan, conflict, drone attacks, and severe water shortages are pushing civilians to the breaking point [2], highlighting the urgent need for safe humanitarian access and additional aid.
Climate drivers and the El Niño threat
Environmental and climate shocks are heavily driving the transmission of the Vibrio cholerae bacterium [1]. The region faces a compounding threat as the El Niño phenomenon is projected to persist through February 2027, elevating the risk of extreme heat, droughts, and severe flooding across East, Horn, and Southern Africa [3]. The International Organization for Migration (IOM) has launched an appeal for USD 110 million to help vulnerable communities mitigate these climate risks [3]. MSF warns that altered rainfall patterns and increased flooding from El Niño will further worsen sanitation conditions [1], which already deteriorated in camps like Dagahaley in the months leading up to May 2023 [1].
Sustained preventative measures required
While cholera has a recovery rate of over 99 per cent when treated promptly [1], the global surge in cases has severely depleted the availability of oral cholera vaccines [1]. MSF medical coordinators emphasise that vaccination campaigns alone, such as the one conducted in Kenya in February 2023, cannot control the disease without long-term investments in clean water, sanitation, and hygiene (WASH) infrastructure [1]. Without immediate improvements in the quality and scale of sanitation, health officials warn that other waterborne epidemics, including hepatitis E, are highly likely to erupt among both newly arrived and long-term refugees who currently lack access to basic latrines [1]. To access emergency medical care or support local water and sanitation initiatives, displaced populations are advised to visit local MSF mobile clinics, which have historically operated in highly affected areas such as the South Omo zone in Ethiopia [1].