South Sudan is battling its largest and longest cholera outbreak since gaining independence in 2011. Beginning in September 2024, the outbreak has persisted for over a year, pushing the country’s health system to its limits and yielding important lessons for managing future epidemics. Nearly 100,000 suspected cases and over 1,500 deaths have been reported across 55 counties in nine states and three administrative areas. However, through strong multi-sectoral coordination, including disease surveillance, rapid response teams, oral cholera vaccination campaigns, and WASH interventions, the number of new infections has dropped sharply—from 1,000 cases per week at the peak in December 2024 to just 114 by late September 2025.
The outbreak, which spread rapidly in its early months due to importations from neighboring Sudan and crowded refugee settlements, initially overwhelmed health facilities. Yet, South Sudan’s response has since stabilized the situation. Transmission has been interrupted in 48 of the 55 affected counties, with more than 90,000 patients successfully treated and discharged. Laboratories tested over 32,000 samples, confirming 12,643 cholera cases, while public health campaigns and targeted vaccinations helped contain the spread even during flooding seasons. Support from donors and partners proved essential to sustain these efforts.
Key lessons have emerged from South Sudan’s one-year cholera response. Active surveillance using rapid diagnostic tests enabled early detection and swift action in new hotspots. Data-driven decision-making, improved water quality monitoring, and community engagement helped guide interventions. Prioritizing oral rehydration points and sub-county vaccination campaigns shortened response times and reduced mortality. These best practices have strengthened national preparedness and improved the country’s ability to manage complex emergencies.
The World Health Organization (WHO) has been instrumental throughout the response, working closely with the Ministry of Health and partners to coordinate operations, provide laboratory tools, deploy medical teams, and train 336 health workers. WHO also helped establish 102 oral rehydration points, 88 treatment units, and 19 treatment centers across the country, while supporting vaccination drives that reached over 8.6 million people—nearly 85% of the targeted population. Through technical assistance and early warning systems, WHO enabled evidence-based planning and resilience building for future outbreaks.
As the country nears the end of the outbreak, WHO and the government remain focused on care for ongoing cases, prevention of resurgence, and strengthening long-term health systems. The response has underscored the importance of cross-border coordination, the engagement of community and religious leaders, and regional solidarity mechanisms like IGAD and the East African Community.
Looking ahead, South Sudan’s cholera experience offers valuable insights for preparedness and resilience. Strengthening surveillance, introducing molecular testing, expanding community-based systems, and ensuring sustainable financing for outbreak response are critical next steps. WHO calls for continued investment in emergency preparedness, regular simulation exercises, and preventive vaccination in high-risk areas. The lessons learned from this outbreak provide a roadmap for building a stronger, more resilient health system capable of protecting lives against future public health emergencies.
