The arithmetic of the Sudan cholera outbreak is grim, and it is mostly not about the bacterium. By 11 August 2025 the World Health Organization counted 48 768 cholera and watery diarrhoea cases in Sudan for the year, with 1094 deaths. That puts the case fatality rate at 2.2 %. The WHO reads anything above 1 % as a sign of serious gaps in case management. The epidemic had begun in 2024.
Where it hit
All 18 of Sudan’s states were affected. Khartoum accounted for 22 225 of the cases, North Kordofan for 7394 and White Nile for 5622, which together made up 72 % of the total. The five Darfur states had all confirmed cholera too, and new cases were turning up in localities near Chad. Its own data carried a warning: surveillance gaps in Darfur meant some places reported late and others not at all.
The death rates varied sharply inside Darfur. The southern state logged 1589 cases and 66 deaths, a CFR of 4.2 %. The eastern state had 517 cases and 26 deaths, a rate of 5%. The northern state, by contrast, reported 3687 cases but the same 26 deaths.
Doctors Without Borders (MSF) reported around the same time that 40 people had died of cholera in Darfur in one week, and that its teams had treated over 2,300 patients in seven days. It pointed to water shortages and a health system in ruins. Tawila, in North Darfur, was especially hard hit; some 380,000 people had fled there from the fighting around El-Fasher.
The mechanics
UNICEF has said the civil war is making the epidemic worse. Water and sewage systems have been damaged or destroyed and many clinics closed for lack of supplies. Millions of displaced people were pushed into overcrowded places with poor sanitation. Then the heavy 2025 rains flooded roads, slowed aid deliveries and left communities without clean water. The WHO added that in Sudan and two neighbouring countries, seasonal flooding and bad roads made it harder for health workers to move and for supplies to arrive.
Money is part of the story too. Global Biodefense, summarising a Center for Global Development analysis from October 2025, reported that the United States, historically the largest humanitarian donor, froze most of its aid in early 2025. The freeze nominally spared lifesaving programmes but left out preventive work on water, sanitation and hygiene, which is what stops cholera spreading. The WHO’s global figures for January to August 2025 were 462,890 cases and 5,869 deaths in 32 countries, with deaths up 118 percent on the same period in 2024.
The toll
The cumulative toll as of November 2025 stood at 124,269 suspected cases and 3,355 deaths. The year 2025 accounted for 71,373 of those cases and 1,996 of the deaths, the largest tally in Africa for the period. Over the previous four weeks new cases had dropped by roughly 44 percent. Even so, with fighting continuing and infrastructure collapsed, the conditions that let cholera spread were still in place.
Sources
- Cholera – Multi-country with a focus on countries experiencing current surges – WHO Disease Outbreak News
- WHO Disease Outbreak News (global context)
- WHO Warns of Worsening Global Cholera Crisis as U.S. Aid Declines – Global Biodefense
- 40 deaths from Sudan cholera outbreak in 1 week, says MSF – DW
