{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:59:01Z","timestamp":1793372341512,"version":"4.5.0"},"reference-count":63,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health\ufffdServ\ufffdInsights"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>Seven years to the Global Taskforce on Cholera Control\u2019s target of reducing cholera cases and deaths by 90% by 2030, Africa continues to experience a high incidence of the disease. In the last 20\u2009years, more than 2.6 million cases and 60\u2009000 deaths of the disease have been recorded, mostly in sub-Saharan Africa. Case Fatality Ratio remains consistently above the WHO-recommended 1% with a yearly average of 2.2%. Between 1 January 2022 and 16 July 2023, fourteen African countries reported 213\u2009443 cases and 3951 deaths (CFR, 1.9%) of the disease. In this perspective article, based on available literature and the authors\u2019 field experiences in Africa, we discuss the underlying reasons for the sustained transmission of the disease. We posit that in addition to the well-known risk factors for the disease, the chronic cholera situation in Africa is due to the poor socioeconomic development status, weak household and community resilience, low literacy levels, weak capacity of African countries to implement the 2005 International Health Regulation and the pervasively weak health system on the continent. Stemming this tide requires good leadership, partnership, political commitment, and equity in access to health services, water, and sanitation. Therefore, we recommend that African governments and stakeholders recognize and approach cholera prevention and control from the long-term development lens and leverage the current cholera emergency preparedness and response efforts on the continent to strengthen the affected countries\u2019 health, water, and sanitation systems. We call on international organizations such as WHO and the Africa Centres for Diseases Control to support African governments in scaling up research and innovations aimed at better characterizing the epidemiology of cholera and developing evidence-based, context-specific, and innovative strategies for its prevention and control. These recommendations require long-term multisectoral and multidisciplinary approaches.<\/jats:p>","DOI":"10.1177\/11786329231211964","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T06:02:29Z","timestamp":1699941749000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["The Chronic Cholera Situation in Africa: Why Are African Countries Unable to Tame the Well-Known Lion?"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6832-873X","authenticated-orcid":false,"given":"Olushayo Oluseun","family":"Olu","sequence":"first","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulmumini","family":"Usman","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida Marie","family":"Ameda","sequence":"additional","affiliation":[{"name":"United Nations Children Fund Eastern and Southern African Regional Office, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nonso","family":"Ejiofor","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freddie","family":"Mantchombe","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick","family":"Chamla","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliet","family":"Nabyonga-Orem","sequence":"additional","affiliation":[{"name":"World Health Organization Regional Office for Africa, Brazzaville, Congo"},{"name":"Centre for Health Professions Education, Faculty of Health Sciences, North-West University, Potchefstroom Campus, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,11,14]]},"reference":[{"key":"bibr1-11786329231211964","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003832"},{"key":"bibr2-11786329231211964","first-page":"453","volume":"97","author":"World Health Organization","year":"2020","journal-title":"Wkly Epidemiol Rec"},{"key":"bibr3-11786329231211964","doi-asserted-by":"publisher","DOI":"10.1007\/82_2014_369"},{"key":"bibr4-11786329231211964","doi-asserted-by":"publisher","DOI":"10.1186\/s41182-021-00376-2"},{"key":"bibr5-11786329231211964","unstructured":"World Health Organization. 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