Yemen bears world’s highest cholera burden, deepening humanitarian crisis

November saw a sharp increase in cholera cases and deaths compared to the same period in 2023, with suspected cases rising by 37 per cent and deaths by 27 per cent.

Yemen’s cholera crisis comes on top of nine years of conflict, widespread economic collapse and crumbling health infrastructure. The country also experienced its largest cholera outbreak in recent history from 2017 to 2020, with transmission persisting ever since.

Unprecedented health crisis

“The outbreak of waterborne diseases like cholera and acute watery diarrhoea imposes an additional burden on an already stressed health system facing multiple disease outbreaks,” said Arturo Pesigan, WHO Representative in Yemen.

“WHO and humanitarian actors are strained in their efforts to address the increasing needs due to severe funding shortages.”

Critical challenges, including inadequate access to clean drinking water, poor sanitation, and limited treatment availability, are fuelling the current outbreak, WHO said.

Severe funding shortages

Yemen’s cholera response faces a $20 million funding gap for the October 2024 to March 2025 response period.

The lack of funds has already forced the closure of 47 diarrhoea treatment centres (DTC) and 234 oral rehydration centres (ORC) between March and November.

An additional 17 DTCs and 39 ORCs are set to close by the end of December, potentially shuttering 84 per cent of DTCs and 62 per cent of ORCs across the country.

Without immediate financial support, health partners warn that Yemen may face another devastating scenario akin to the 2017-2020 outbreak, which overwhelmed its fragile healthcare system.

Response efforts

Since the emergence of the latest cholera outbreak in March 2024, WHO has worked closely with Yemeni authorities, UN agencies and humanitarian partners to manage the outbreak.

Key efforts include deploying over 25,000 rapid response team missions to investigate alerts and implement control measures. WHO also supplied laboratory reagents and supplies to 12 central public health laboratories to confirm infections.

It also distributed essential medicines, medical supplies, and water, sanitation, and hygiene (WASH) materials to health facilities, as well as training more than 800 health workers were trained on cholera case management and supporting an oral cholera vaccination campaign that reached 3.2 million people across six governorates.

Humanitarian challenges

The cholera crisis is just one facet of Yemen’s broader humanitarian crisis.

The conflict has left 18.2 million people, nearly half the population, in need of humanitarian assistance, with 11.2 million slated for aid coverage.

Across the country, some 17.6 million people are affected by food insecurity, while almost half of all children under five suffer from moderate to severe stunting.