Despite a decline in cholera cases in Nigeria this year, the country’s persistently high fatality rate—3.5%—underscores critical gaps in healthcare access, sanitation infrastructure, and vaccine availability. With hotspots like Lagos, Borno, and Katsina bearing the brunt, systemic challenges and delayed responses continue to hinder outbreak control and expose millions to preventable deaths.
Nigeria remains at the center of Africa’s ongoing cholera crisis, reporting 17,139 cases and 603 deaths between January and October 2024. According to the World Health Organization’s latest report, the country’s cholera fatality rate (CFR) of 3.5% is one of the highest on the continent, well above the 1% threshold considered acceptable for outbreak response.
In October alone, Nigeria recorded 3,179 new cases and 87 deaths, marking a decline of 44% and 62% respectively compared to September. However, the slightly reduced CFR of 2.7% still signals a pressing public health emergency.
The disease has spread across all 36 states, but Lagos, Borno, and Katsina have emerged as hotspots, accounting for over half of the national caseload. High population density, limited access to clean water, and poor sanitation in these states have created an ideal breeding ground for cholera. Flooding and displacement from conflicts in northern regions have further exacerbated the spread of the disease.
Cholera in Nigeria – Fast Facts (2024)
- Cases reported: 17,139
- Deaths: 603
- Most affected states: Lagos, Borno, Katsina
- Case Fatality Rate (CFR): 3.5%
Nigeria’s cholera response faces significant challenges. Poor access to clean water and sanitation infrastructure continues to fuel outbreaks, particularly in rural and flood-affected areas. The lack of timely healthcare access also contributes to the high fatality rate, as many patients seek treatment only after severe complications develop. Moreover, a global shortage of oral cholera vaccines (OCVs) has restricted Nigeria to reactive vaccination campaigns, leaving little room for preventive measures. Compounding the crisis, the overstretched healthcare system struggles to respond effectively as cholera competes for resources with other public health emergencies.
In collaboration with Nigeria’s Ministry of Health, the WHO said it has taken measures to mitigate the crisis. Experts have been deployed to support outbreak management, and cholera kits have been distributed to affected areas. Training materials and guidelines have been provided to strengthen local capacities, while reactive vaccination campaigns have targeted high-risk populations. Despite these efforts, the persistently high CFR highlights the need for more robust and sustained interventions.
The WHO emphasizes the importance of prioritizing water, sanitation, and hygiene (WASH) interventions to address the root causes of cholera. Investments in clean water supply, improved sanitation, and public health education are crucial to breaking the cycle of recurring outbreaks. Additionally, scaling up the global production and availability of OCVs is critical to enabling both preventive and reactive vaccination campaigns.
Nigeria’s struggle with cholera is a stark reminder of the broader systemic challenges in public health across Africa. Without a concerted effort to address these issues, WHO argues the country remains vulnerable to recurring outbreaks and preventable loss of life.