Africa's health marked by a year of successes and challenges

In 2025, Africa's health sector presented a compelling narrative of contrasts - a year marked by disease elimination milestones even as the continent battled some of its worst outbreaks in decades.

"For children and vulnerable communities, 2025 has been a complex landscape marked by the recurrence of public health emergencies," said Dr Edna Moturi, United Nations Children's Fund Regional Health Emergency Specialist for Eastern and Southern Africa. "We have seen outbreaks of cholera, mpox, viral hemorrhagic fevers such as Marburg, and also Ebola."

Moturi also expressed concern about the uptick in vaccine-preventable diseases. 

"We have seen a lot of routine immunization programs stagnating and even declining, and so we are having more and more outbreaks of polio and measles.”

Cholera: Africa's worst outbreak in 25 years

The cholera situation in Africa during 2025 reached crisis proportions, with the Africa CDC declaring it the continent's worst outbreak in 25 years. By November, approximately 300,000 confirmed and suspected cases had been recorded, along with more than 7,000 deaths, a 30 percent increase over the previous year.

Cholera is a severe and potentially fatal diarrheal disease that spreads quickly when sewage and drinking water are not adequately treated.

Sudan, the Democratic Republic of Congo, South Sudan and Nigeria recorded the highest numbers of cholera cases.

In August, the Africa CDC and the World Health Organization (WHO) launched the Continental Cholera Emergency Preparedness and Response Plan for Africa 1.0, with African heads of state pledging to control and eliminate outbreaks by 2030.

Mpox dominates among recurring outbreaks

Mpox continued to be a major concern throughout the year, spreading well beyond its traditional boundaries. Data from the Africa CDC shows that between January 1 and November 23, 28 African countries reported 42,147 confirmed cases of mpox, resulting in 192 deaths. The countries with the highest number of confirmed cases this year include the Democratic Republic of the Congo, Liberia, Ghana, Kenya and Uganda.

Mpox is a viral infection that spreads through close contact and typically causes flu-like symptoms and pus-filled lesions. It is usually mild, but can be lethal.

To combat further spread, thousands of vaccine doses were delivered by organizations to countries that are most affected.

Marburg outbreaks and preparedness challenges

Marburg virus disease—a viral hemorrhagic fever—made alarming appearances in new territories in Africa. Ethiopia reported its first-ever outbreak in Jinka town in November, a situation that health authorities are still monitoring closely.

As of December 3, Ethiopia reported laboratory-confirmed Marburg among 14 people, nine of whom have died, according to the CDC. The case fatality rate is approximately 57 percent.

Earlier in the year, Tanzania also fought a high-fatality Marburg outbreak. The East African nation would then declare the end of the outbreak in March in accordance with WHO recommendations.

Moturi said the underlying causes for the outbreaks across the continent were multifaceted. 

"I think also in the continent, we have had a lot of shocks from climate disasters where we have seen protracted droughts, we have had severe flooding and we have also seen conflicts in many countries, all of which are triggering population displacement, where people are having to move to areas that are really not suitable for human conditions."

She notes that constraints on humanitarian funding, not just for emergencies but also for disease control programs, "really strained Africa's health systems."

Proof of progress, even amid pressure

Despite the challenges, there were many accomplishments recorded in Africa.

Uganda contained a Sudan virus disease outbreak in less than three months. The outbreak was declared on January 30 after a 32-year-old nurse died. Three other people also died during that outbreak.

In November, the WHO announced that Egypt eliminated trachoma as a public health problem, marking the seventh country in the WHO Eastern Mediterranean Region to achieve this feat and the 27th globally.

WHO also validated Senegal as having eliminated trachoma as a public health problem, becoming the ninth country in WHO's African Region to achieve this milestone.

Kenya was officially recognized for eliminating Human African Trypanosomiasis as a public health problem, making it the 10th country to achieve this milestone. This achievement marks Kenya's second success in tackling neglected tropical diseases following its certification as Guinea worm–free in 2018.

"The countries we've seen with successes have invested in building their health systems, resilience and preparedness. By maintaining strong primary healthcare, we are able to increase access to care and not just care but preventive services," Moturi explained.

Moturi also highlighted the WASH (Water, Sanitation, and Hygiene) initiative as a key factor in disease prevention. 

"WASH has really been identified as one of the key drivers for diseases, so these countries have invested in really providing adequate water, sanitation and hygiene programs, and all these preventive services go a long way in making sure communities are strong."

Looking forward: lessons for the year ahead

For 2026, the emphasis must be on preparedness. 

"Emergencies are becoming more and more frequent, and one of the key lessons we have looked at is honestly the investment in preparedness," Dr Moturi stressed. "Now, when I look forward to 2026, we are able to really map out the seasons where certain diseases are going to be high. We know the risk factor. For example, we know that it is a cyclone season, the cholera season, so really advocating for investment in preparedness."

She called on donors to move beyond a response-driven approach, noting that funding typically comes only during outbreaks, and emphasized the importance of investing in preparedness and robust surveillance.