War on cholera can’t be won without water and sanitation

3 min read

WaterAid has warned that global efforts to end cholera will fail unless the world’s poorest are given the tools they need to fight the disease – clean water, decent sanitation and good hygiene.

A new report by WaterAid, ‘The war to end cholera’ reveals the countries with the highest cholera burden are also the same nations with the greatest number of people living without clean water and decent sanitation.

The report has been released ahead of the launch of a new global roadmap to end cholera within a generation. The new roadmap - organised by the Global Task Force for Cholera Control (GTFCC) - aims to reduce cholera deaths by 90% by 2030 and eliminate the disease as a threat to public health in up to 20 countries by 2030.

India tops the list of countries with the highest estimated number of cholera cases globally (675,000). It also has the greatest number of people living without access to clean water (163 million) and a decent household toilet (732 million), the WaterAid report shows.

Ethiopia and Nigeria follow in second and third place respectively. Both nations also have the second and third highest number of people globally living without access to clean water, and they rank among the top for having the most people without basic sanitation.

Tom Muller, WaterAid Australia’s Director of Policy and Programs, said:

“Cholera has no place in the 21st century. Looking around the world, the map of cholera outbreaks is essentially the same as a map of poverty and marginalisation. The fact that this preventable disease still sickens 2.9 million people every year and kills 95,000 people is a global badge of shame. 

“But cholera can be eliminated with the simple things we already know work. With the right international and national political commitment, and by arming people with clean water and decent sanitation, we can win the war against cholera and consign this deadly disease to the history books in our lifetime.”

The GTFCC – which brings together government and non-governmental organisations, including WaterAid, UN agencies such as the World Health Organization, and scientific institutions – launched the new plan called ‘Ending Cholera – A Global Roadmap to 2030’ during a high-level meeting in Annecy, France on 4 October. 

Key facts

  • Cholera still affects more than 40 countries across the globe
  • There are 2.9 million cholera cases each year and as many as 95,000 deaths
  • Globally 844 million people still lack basic access to drinking water, and 2.3 billion are without a decent household toilet, potentially exposing them to a range of water-related diseases including cholera
  • Cholera costs the world an estimated $2 billion per year in treatment and hospitalisation and the related lost productivity 

The global burden of cholera

Country Estimated 
to water
India 675,188 1 732,207,000 1 163,105,959 1
Ethiopia 275,221 2 92,354,960 4 60,504,853 2
Nigeria 220,397 3 122,802,379 3 59,498,110 3
Haiti 210,589 4 7,439,501 35 3,837,313 36
DRC 189,061 5 62,034,676 7 44,939,929 5
Tanzania 161,904 6 40,886,656 8 26,657,528 7
Kenya 111,273 7 32,306,737 9 19,130,780 9
Bangladesh 109,052 8 85,449,092 5 4,303,184 32
Uganda 89,726 9 31,557,309 10 23,840,407 8
Mozambique 78,613 10 21,386,074 15 14,755,876 12


*** https://washdata.org

**** WaterAid analysis