Healthcare facilities in Borno State are under increasing pressure following a rise in suspected cholera cases, with more than 35,500 people infected and 198 deaths recorded since May.

In a statement sent to PREMIUM TIMES on Wednesday, Médecins Sans Frontières (MSF), also known as Doctors Without Borders, cited data from the Borno State Ministry of Health showing that the outbreak has spread rapidly since the first suspected cases were reported on 1 May.

The organisation attributed the surge to overcrowded informal settlements, limited access to safe drinking water, poor sanitation and inadequate waste management.

MSF said the growing number of infections has overwhelmed healthcare facilities, with health workers struggling to keep pace with patients requiring treatment.

Response

Cholera is an acute bacterial infection transmitted through contaminated food and water. It causes severe watery diarrhoea and dehydration, and can become life-threatening within hours if treatment is delayed.

Given the danger of the disease, MSF said it has expanded its emergency response in collaboration with health authorities and other humanitarian organisations by supporting two Cholera Treatment Centres, five Cholera Treatment Units and 17 oral rehydration points across Borno State.

The organisation said it had treated more than 24,000 patients with suspected cholera as of 12 July, adding that more than one in four arrived with severe symptoms.

Speaking on the outbreak, Bienfait Tombola, MSF project medical coordinator in Maiduguri, said the organisation had significantly expanded its response over the past two months.

However, he noted that the disease was continuing to spread faster than efforts to contain it, mainly because many communities still lacked access to clean water, sanitation and healthcare.

Limited awareness

Beyond the strain on health facilities, MSF said limited public understanding of how cholera spreads remains a challenge to containing the outbreak.

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According to the organisation, it has intensified community awareness campaigns, trained healthcare workers in cholera management, and supported water, sanitation, and hygiene interventions, including chlorinating water at key collection points.

It added that health authorities, with support from MSF, conducted an oral cholera vaccination campaign in early July, reaching more than 2.6 million people.

Despite these efforts, the organisation said many communities, particularly those in informal settlements, continue to lack access to safe water, sanitation and healthcare, allowing transmission to persist.

MSF also noted that the outbreak has spread beyond Borno to neighbouring Plateau State, where the state Ministry of Health had reported 102 suspected cholera cases as of 12 July.

The organisation stressed the need to strengthen access to clean water, sanitation, disease surveillance and timely treatment, while expanding vaccination campaigns in affected communities to curb transmission and prevent further deaths.

The World Health Organisation (WHO) has warned that nearly 2.7 billion people worldwide still cannot afford the minimum diet needed for good health, despite improvements in access to healthy diets in recent years.

Speaking in a video posted on X on Tuesday, the WHO Director-General, Tedros Ghebreyesus, noted that more than 200 million additional people were able to afford a healthy diet last year compared with 2021, but said the progress remains far from sufficient.

Mr Ghebreyesus said the burden is unevenly shared, with Africa disproportionately affected, as about two-thirds of the continent’s population cannot afford a healthy diet.

Africa bears heaviest burden

Mr Ghebreyesus said Africa remains the region most affected by the high cost of nutritious food, with about two-thirds of its population unable to afford a healthy diet.

He warned that the situation is even more difficult in some of the world’s most vulnerable settings, where conflict, displacement and climate change are driving unprecedented levels of acute malnutrition, particularly among children.

According to him, while the WHO is supporting countries to respond to the immediate nutrition crisis, governments must also address the underlying factors that make healthy diets inaccessible.

“We must also act upstream. We know what works,” he said.

Policy actions

Mr Ghebreyesus outlined several measures that governments can adopt to improve access to healthy diets.

These include promoting breastfeeding, taxing unhealthy foods and drinks while subsidising healthier options, protecting children from the marketing of unhealthy industrially produced foods and beverages, introducing clear front-of-pack nutrition labelling to help consumers make healthier choices, reformulating food products to reduce salt, sugar and trans fats, and strengthening primary healthcare systems to prevent, detect and manage all forms of malnutrition.

He said implementing these interventions would make healthy diets more available, affordable and accessible to everyone.

“Healthy diets should not be a luxury. They are the foundation of health, and they should be within everyone’s reach,” he said.

Nigeria’s context

The WHO warning reflects Nigeria’s growing struggle with the affordability of nutritious foods, as rising food prices—where common protein sources often cost thousands of ₦ per unit—continue to limit access to balanced diets for many households.

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A balanced diet typically includes carbohydrates, proteins, healthy fats, fruits and vegetables, providing the nutrients needed for healthy growth, development and disease prevention. According to the National Bureau of Statistics (NBS), although food inflation has slowed in recent months, many nutrient-rich foods, including vegetables, fruits, eggs, fish and other protein sources, remain beyond the reach of low-income families.

The challenge has contributed to Nigeria’s persistent malnutrition burden. Findings from the Nigeria Demographic and Health Survey (NDHS) 2023–24 show that about 40 per cent of children under five are stunted, while eight per cent are wasted, highlighting the continued impact of poor nutrition on child health.

The affordability crisis is further compounded by insecurity in several parts of Nigeria, where conflict continues to disrupt food production, livelihoods and access to healthcare. PREMIUM TIMES has reported extensively on how armed conflict and displacement, particularly in the North-east, have worsened hunger and malnutrition by forcing families from their homes, limiting access to farmland and disrupting humanitarian assistance in affected communities.