Malawi is facing its deadliest cholera outbreak in recorded history and its largest in the last two decades, leaving 4.8 million people in need of assistance in 15 priority districts. The outbreak was officially declared on 3 March 2022, after the first case was reported in Machinga district at the end of February 2022. By 18 February 2023, the outbreak had claimed the lives of more than 1,400 people, with more than 45,400 cases recorded, and had an overall case fatality rate (CFR) of 3.21 per cent, more than three times the emergency threshold. The current outbreak has already surpassed the 2001-2002 epidemic, which was the worst in the country’s recent history, that registered 33,000 cases and 1,000 deaths.
The outbreak has escalated exponentially in recent months. In the early months of the outbreak, the number of monthly cases remained below 60, but this increased to more than 300 cases in May, nearly 800 cases in August and more than 2,000 cases in October. The start of the rainy season in November 2022 saw a rapid escalation in the outbreak—with more than double the number of cases (more than 4,700) compared to October (more than 2,000)—and cases then rose precipitously in the first weeks of January 2023, with an average growth rate of 3 per cent per week.