Cholera in Africa: new momentum in fighting an old problem.

Cholera remains a grave public health problem in Africa. It is endemic with seasonal variations around the central African Great Lakes. Along the coasts, it occurs mostly in rapidly expanding epidemics, with intercalated 3-5 year lull-periods. Case-fatality ratios remain high at 2–5% against the global declining trend. Insufficient safe water and sanitation coverage are the main causes of persistent cholera in Africa and this is unlikely to improve soon. However, an efficacious oral cholera vaccine is now available and new groups and initiatives like the African Cholera Surveillance Network (Africhol) allow countries to enhance their capacities for an integrated cross-border approach using all means necessary to tackle cholera in Africa.