As climate change intensifies, extreme weather is becoming more frequent and more powerful -- and this could be contributing to a global uptick in cholera.

One such example happened in Malawi in early 2022, after tropical storms Ana and Gombe caused devastating flooding amid an already-heavy rainy season.

“That March, we started to see cholera, which is usually endemic in Malawi, becoming an outbreak,” said Gerrit Maritz, a deputy representative for health programs in Malawi for the United Nations Children’s Fund.

Cholera is a diarrheal illness that spreads in places without access to clean water and sanitation, when people swallow food or water contaminated with Vibrio cholerae bacteria.

The World Health Organization says that while poverty and conflict remain enduring drivers for cholera around the world, climate change is aggravating an increase of the disease that was first noted in 2021. According to the WHO, 30 countries reported outbreaks in 2022, 50% more than previous years’ average; many of those outbreaks were compounded by tropical cyclones and their ensuing displacement of people.

“Malawi’s water-sanitation indicators were already extremely bad,” UNICEF public health emergency specialist Raoul Kamadjeu said, “but the storms made a bad situation worse.”

Spikes in cholera cases were then reported in Zambia, Mozambique, Pakistan and in Nigeria.

In response to the cholera surge and resulting shortage of the usual vaccine supply, the international coordinating group for cholera vaccines changed its vaccination protocol in October from two doses to one, reducing protection length of time.

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