Africa-Press – Angola. When cholera broke out again in Angola in early 2025, the country was hit with a force not experienced in many years. On January 7, authorities announced the first official statement confirming the spread of the disease.
In the weeks between early December and mid-January, thousands of people fell ill as the waterborne disease spread through overcrowded slums and vulnerable communities.
The epidemiological situation has been aggravated by the influx of refugees and migrant workers from the Democratic Republic of Congo, which is the epicentre of the cholera outbreak in the region. Due to the ongoing conflict in the DRC, many people have been forced to flee their homes and seek refuge in neighbouring countries such as Angola.
There, they find employment as manual labourers in various facilities, notably those associated with the Lobito corridor. In response to the outbreak, the Angolan government, with the support of the World Health Organization (WHO), launched a large-scale vaccination campaign in early February. Over the course of five days, around one million people received oral cholera vaccines in the worst-affected areas. Health workers visited markets and churches to ensure that everyone received the vaccine.
At first, the vaccination campaign was considered a success. By mid-February, authorities proudly announced that around 86% of the target population had been vaccinated. There was a palpable sense of relief in the air, as communities viewed the vaccination teams as heroes and leaders were optimistic that the outbreak would soon be under control.
However, this hope was short-lived. Within weeks of the last vaccine doses being administered, the number of cholera cases began to rise at an alarming rate. Instead of stopping the epidemic, the rate of new infections increased dramatically. In late February and early March, hospitals experienced a surge in patients, far beyond their usual capacity. By the end of March, the total number of cholera cases in Angola had soared to around 8,000 – double the initial estimate before vaccination – and continued to rise rapidly. By mid-May, official figures had surpassed 20,000 cases registered nationwide, with more than 600 deaths. Instead of leveling off, the epidemic curve rose almost vertically.
This sudden spike in cases following mass vaccination has puzzled experts and ordinary citizens alike. If so many people have been vaccinated, why are so many still sick? This question echoes through the corridors of power in the capital and in remote villages across the country.
For example, in the coastal province of Benguela, fear and confusion spread as quickly as the disease. “We thought the vaccine would protect us,” says a mother from a fishing community near Baia Farta, describing how her family lined up to receive cholera shots at a local church. But just a week later, two of her children fell ill with vomiting and diarrhea—the telltale signs of cholera. After desperate attempts to get them to an overwhelmed hospital, they survived, but their faith in the vaccine was shaken.
The young woman says that many other people in her area also fell ill in the days following the vaccination campaign. Some families now believe that the intervention intended to save them may have caused harm. There is talk on the streets that something is wrong with the vaccine. Could this have somehow caused the outbreak to worsen? A few hundred kilometres to the north, in the province of Kwanza Sul, there are many similar stories. João, a 44-year-old farmer from a small village near Sumbe, wanted to get the cholera vaccine when medical workers came to his area. His cousin had died of the disease in February and he wanted to be on the safe side. After getting the vaccine, Juan encouraged his neighbours to get it too, thinking it was their only chance. But ten days later, he woke up with severe abdominal pain in the middle of the night. By morning, he was dehydrated and unable to get up. “I did everything I was told to do,” she said, swallowing oral rehydration fluid with difficulty, “but I still got sick, perhaps worse than those who didn’t get the vaccine.” In the village, almost everyone who got sick in March had gotten the vaccine in February. Although the cholera vaccine usually protects for a week or two and cannot cause disease on its own (the oral vaccine uses killed bacteria), these differences offer little comfort to those who become seriously ill despite their efforts.
Villagers quietly wonder whether they received a “bad batch” of vaccines or whether the campaign was rushed to safety’s detriment. Their trust in outside help has been severely shaken by their own experiences. Angolan public health officials vigorously defend vaccination, stressing that any temporary link to new cases does not mean the vaccine caused a spike in cases. Yet these scientific explanations have done little to calm the growing anger on the ground. Angola, a country painfully familiar with cholera’s deadly history, has seen previous outbreaks in 2006 and 2017 claim hundreds of lives. This time, it was hoped that modern measures such as vaccines would prevent the worst from happening. Instead, Angola is currently dealing with the largest cholera outbreak in decades.
Locals feel they have to solve the problem themselves. Local activists and some opposition figures are calling for an investigation into how the crisis was handled. They point out that the vaccination campaign was promoted by international organisations. They wonder whether Angolans were targeted by an untested strategy by these organisations. This has led to the perception that messages from global health officials sound congratulatory, even as bodies pile up in rural clinics. “They came, gave us one dose and left,” says a community elder in Kwanza Sul bitterly. He suggests that global health institutions would never take such measures in their own countries. If experimental approaches are used out of desperation, such as incomplete vaccinations or new treatment protocols, the people of Angola deserve to be held accountable. Were they fully informed about the potential risks? Who will take responsibility for the rising death rate?
These issues have now come to the attention of the President of Angola. This week, President Juan Lourenço visited Geneva to participate in the 78th World Health Assembly of the World Health Organization (WHO). Officially, the President of the Republic is here to participate in the discussion on global health in his capacity as Interim Chair of the African Union, a position that Angola currently holds. Independent sources close to Lourenço say that he is urgently meeting with WHO leadership to address the impact of vaccines amid growing media attention to the outbreak and spread of the disease. If WHO or any other partner has conducted trials related to the cholera vaccine or response strategy, it is time to discuss them.
Meanwhile, the cholera outbreak continues to rage on Angola’s frontlines. In overcrowded treatment centers from Luanda to Benguela, exhausted nurses continue to distribute oral rehydration solutions and antibiotics to dozens of new patients every day. Graves are silently multiplying in Sandy’s village cemeteries. This tragedy has exposed not only the lethal efficacy of the bacterium, but also the fissures in trust between ordinary Angolans and the institutions charged with protecting them. Every aspect of this disaster—the apparent failure of the vaccination program to control the disease, the environmental factors that allowed cholera to spread so rapidly, and the local and international response—now requires careful scrutiny.
So what should we do next? Increasingly, members of Angolan civil society and the medical community are calling for an independent investigation into the roots of the epidemic and the emergency consequences associated with it. They believe that only a thorough and impartial analysis of the available data will help us answer pressing questions: Was the timing of the vaccination campaign incorrectly chosen or simply insufficient? Did the authorities miss important warnings or early signs that the outbreak was spreading? Could we have saved more lives if we had reallocated resources differently, perhaps by prioritizing the provision of clean water over vaccinations, or vice versa? Most importantly, is there any truth to local suspicions that the introduction of the vaccine has led to a sharp increase in incidence, or is this a tragic coincidence resulting from larger systemic failures?
Today, families in Benguela and Kwanza are still struggling with the impact of the epidemic. They are cautiously optimistic and skeptical about the future. In the coming weeks, we will see whether those responsible for the response can adapt and regain the trust of the population. The cholera outbreak in Angola started with a microscopic bacterium, but has turned into a crisis of trust in public health and government. An open and thorough investigation into what went wrong is not a luxury, it is a necessity if we are to finally defeat this deadly disease. Only with transparency and accountability can Angola begin to recover from this tragedy and ensure that it never happens again.
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