In mid-March 2024, cases of acute watery diarrhea started to appear in several governorates in Yemen, some of them suspect of being cholera cases. The origins of these cases are reportedly in contaminated food, vegetables and vegetable distribution sites, due to the use of black water to irrigate agricultural cropland.

According to the Yemen WASH Cluster, 20 out of 21 governorates in Yemen have recorded acute watery diarrhea cases, with more than 22,000 cases reported as of 1 May 2024. MSF is responding in seven governorates, by doing preventive activities (distributions, health promotion and awareness) and curative activities (case management and treatment). Across Yemen, our teams are running and/or working/supporting in seven Acute Watery Diarrhea (AWD) treatment units and working in three other cholera treatment centres.

Yemen has been seeing recurrent surges in numbers of acute watery diarrhea and cholera in the previous years, with the biggest of them being reported in 2017, considered to be one of the largest and fastest-spreading outbreaks in modern history.

Yemen’s infrastructure has been severely impacted by a decade of war, and such an outbreak is a result of that. In the past two years, donors have decreased their funds and humanitarian support in the country, adding another layer of challenges to an already dire system. An increased implementation of WATSAN activities is needed by international actors, and the limited response of health organisations is also worrying.

At an international level, the number of cholera rapid tests and cholera vaccines are considerably limited, with several simultaneous outbreaks in dozens of countries, and the existing stock worldwide will never be sufficient to cover all outbreaks.