Active Public Health Outbreaks: WHO Eastern Mediterranean Region
As of November 2025, the WHO Eastern Mediterranean Region (EMRO) is navigating a complex landscape of concurrent public health emergencies. The region, which includes 22 countries from Morocco to Pakistan, is currently the global epicenter for several infectious disease outbreaks, driven largely by protracted conflicts, climate-induced disasters, and the collapse of sanitation infrastructure.
The most critical situations are observed in Sudan, Gaza, and Yemen, where war has dismantled health systems, allowing ancient scourges like cholera and polio to resurge with unprecedented ferocity.
Cholera: The Dominant Regional Crisis
Cholera remains the most widespread and lethal outbreak in the region. By late 2025, the Eastern Mediterranean accounted for approximately 74% of the global cholera burden. The convergence of conflict and flooding has created "perfect storm" conditions for Vibrio cholerae, particularly in Sudan and Yemen.
Sudan's Escalation (2024–2025)
Since mid-2024, Sudan has experienced its longest recorded outbreak. The collapse of water infrastructure in Khartoum and Darfur has fueled transmission.
Regional Hotspots
- Yemen Endemic status; >271,000 suspected cases since Mar 2024. Accounts for ~89% of regional burden excluding Sudan.
- Somalia High infection rates driven by post-drought flooding.
- Syria High risk of resurgence due to water scarcity in northern governorates.
The Gaza Health Emergency
The situation in Gaza is characterized by the WHO as "spiraling out of control." The systematic dismantling of the healthcare system has left the population vulnerable to outbreaks that were previously eliminated or controlled.
Functional Health Facilities (Nov 2025)
out of 36 total
Active Disease Threats
- Polio (cVDPV2): Environmental detection confirmed; first paralytic case in 25 years reported in late 2024. Mass vaccination campaigns are ongoing but hindered by access.
- Skin Infections: >60,000 cases of rash and >9,000 cases of chickenpox reported. Scabies and lice are rampant due to overcrowding.
- Respiratory & Diarrheal: Hundreds of thousands of cases of upper respiratory infections and acute watery diarrhea.
Polio: The Final Frontier
Afghanistan and Pakistan remain the only two countries where Wild Poliovirus Type 1 (WPV1) is endemic. While 2024 saw a concerning spike in cases, 2025 has shown a mixed picture with persistent environmental detection.
| Country | 2024 WPV1 Cases | 2025 Status (Nov) | Key Challenges |
|---|---|---|---|
| Pakistan | ~74 | 13 confirmed cases; widespread environmental positives. | Security gaps in KP and Balochistan; vaccine boycotts. |
| Afghanistan | 25 | Low case count (1 confirmed), but environmental samples persist. | Repatriation of refugees; access to remote southern regions. |
Vector-Borne Diseases
Climate change and urbanization are expanding the range of mosquito vectors in the region.
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Dengue Fever
Sudan: Severe outbreak with >24,000 cases in 2025 alone.
Iran: Rare autochthonous (locally acquired) cases detected, signaling a geographic expansion of the vector. - Malaria Remains a major co-infection in Sudan, complicating the clinical management of dengue and cholera patients.
Measles Resurgence
Gaps in routine immunization, exacerbated by the COVID-19 pandemic and conflict, have led to a sharp rise in measles cases.
Increase in Measles cases in EMRO (2024 vs 2019)
High Burden Countries: Yemen (>41k cases), Iraq (~30k cases), Pakistan (~18k cases).