The World Health Organization (WHO) reports that Yemen bears the highest burden of cholera in the world. According to a WHO report released earlier this week, there are approximately 250,000 suspected cases of cholera reported, with more than 860 associated deaths since the beginning of the year, accounting for 35 percent of the global cholera burden and 18 percent of the global reported mortality.
While attention has shifted to other global emergencies, Yemen remains one of the world's most severe and protracted humanitarian crises after nine years of war, with an estimated 19.5 million people - more than half the population - in need of assistance and protection in 2025.
Yemen, engulfed in protracted conflict and economic collapse, has some of the highest malnutrition rates in the world. Ongoing conflict, economic instability and recurrent disease outbreaks remain the main drivers of the country's humanitarian crisis.
The country has experienced persistent cholera transmission for many years, including the largest outbreak in recent history - between 2017 and 2020.
As of December 1, the number of cases and deaths reported in November 2024 is 37 percent and 27 percent higher than the same month in 2023. This year's increase is largely due to updated data from Yemen, with adjustments made to account for more detailed information from all governorates, WHO said.
"The outbreak of waterborne diseases like cholera and acute watery diarrhea imposes an additional burden on an already stressed health system facing multiple disease outbreaks,"said Arturo Pesigan, WHO Representative and Head of Mission in Yemen, in a statement.
“WHO and humanitarian actors are strained in their efforts to address the increasing needs due to severe funding shortages.”
Pesigan warned that lack of access to safe drinking water, poor community hygiene practices and limited access to timely treatment further hamper efforts to prevent and control the disease.
According to WHO, addressing cholera in Yemen requires urgent and comprehensive interventions, including coordination, surveillance, laboratory capacity, case management, community engagement initiatives, water, sanitation and hygiene (WASH), as well as oral cholera vaccination.
The UN agency said timely and sufficient funding is necessary for these interventions. In addition, damaged public water and sanitation infrastructure requires intensive rehabilitation to prevent a recurrence of the devastating scenario the country experienced between 2017 and 2020.
Based on incidence projections conducted in September for the response period between October 2024 and March 2025, the cholera response in Yemen faces a funding gap of US$20 million.
According to WHO, between March and the end of November 2024, 47 diarrhea treatment centers (DTCs) and 234 oral rehydration centers (ORCs) were closed due to lack of funding. An additional 17 treatment centers and 39 rehydration centers will be closed by the end of 2024 unless additional funding is provided to aid agencies.
In a related development on Thursday, Israeli air strikes hit Sanaa International Airport - which is controlled by Houthi rebels - as a high-level UN delegation, led by WHO Director-General Tedros Adhanom Ghebreyesus, was at the airport. The UN delegation had just concluded talks on the humanitarian situation in Yemen and the release of UN and other detained staff when the Israeli airstrikes reportedly caused numerous casualties, including at least three deaths and dozens of injuries.
"As we were about to board our flight from [Sanaa, around 5 pm. local time], the airport came under aerial bombardment," the WHO chief said in a statement.
A crew member of the United Nations Humanitarian Air Service (UNHAS) was also seriously injured when the airport was hit.
“The air traffic control tower, the departure lounge — just a few meters from where we were — and the runway were damaged,” Ghebreyesus said.
Thursday's airstrikes follow about a year of escalating actions by the Houthis in the Red Sea and the region that threaten civilians, regional stability, and freedom of maritime navigation.
In a statement issued by his spokesperson on Thursday, UN Secretary-General António Guterres condemned the escalation between Yemen and Israel, noting that Israeli airstrikes on Sanaa International Airport, Red Sea ports and power plants in Yemen were particularly alarming.
Stressing that international law, including humanitarian law where applicable, must be respected at all times, Guterres called on all to respect and protect civilians and civilian infrastructure.
Attacks on civilian infrastructure and the targeting of humanitarian personnel are war crimes under international law. Humanitarian personnel must not be targeted and must be respected and protected at all times.
Through his spokesperson, the Secretary-General expressed his deep concern at the risk of further escalation in the region and reiterated his call for all parties to the conflict to cease all military action and exercise the utmost restraint.
He also warned that airstrikes on Red Sea ports and the Sanaa airport pose a grave risk to humanitarian operations at a time when millions of people are in need of life-saving assistance.
In 2024, Houthi forces continued their attacks on international shipping and made several attempts to target Israel with rockets and drones. In response to these attacks, there were multiple Israeli airstrikes on Hudaydah, a major entry point for humanitarian aid into impoverished Yemen.
Military escalation following Israeli airstrikes on targets across the country risks worsening an already dire situation for civilians, and could also undermine Yemen's fragile peace process and longer-term recovery. As the conflict in Gaza drags on, the state in the south of the Arabian Peninsula - now in its tenth year of conflict - risks being drawn further into it.
“Further escalation in the region also continues to undermine the mediation efforts led by the Special Envoy of the Secretary-General for Yemen, Hans Grundberg, to reach a negotiated political solution to the conflict in Yemen,” Guterres added.
Grundberg is the UN official tasked with brokering a sustainable solution to the conflict.
The Secretary-General reiterated his call for the immediate and unconditional release of all UN and other personnel arbitrarily detained by the Houthis. Dozens of men and women are still being held by the Houthis in unknown locations. Among those detained are 17 United Nations staff members.
According to UN officials, the arbitrary detention of humanitarian personnel and false charges against them continue to severely impede international efforts to provide life-saving humanitarian assistance in Yemen.
The Houthis control large parts of Yemen after capturing the capital and ousting the internationally recognized government in September 2014. The conflict between a Saudi-led coalition of Gulf states and the ousted Yemeni government against the Houthi rebels - also known as the Ansar Allah movement - escalated in 2015, when Saudi Arabia began airstrikes against Houthi and Houthi-affiliated forces.
More than two and a half years ago, a six-month ceasefire was announced between Yemen's warring parties. While the UN-brokered ceasefire has not been renewed, there has been a fragile continuation of truce-like conditions. As a result, the level of violence has decreased and progress has been made in political negotiations.
While the reduction in armed conflict in the country since April 2022 has led to a decrease in civilian casualties and suffering among the population, the situation remains fragile without a lasting political solution.
Yemen is also one of the most climate-vulnerable countries in the world. And it is among the least prepared to mitigate or adapt to the impacts of climate change-induced natural hazards, such as floods, which are becoming more frequent.
The country's dire situation is compounded by ongoing displacement and severe funding shortages. Across Yemen, 4.56 million people have been internally displaced by the conflict. Of these, 80 percent are children and women.
Across the country, some 17.6 million people are severely food insecure, with 5 million facing emergency levels of food insecurity. Some 3.5 million people are acutely malnourished, including more than 500,000 who are severely acutely malnourished.
Lack of adequate funding continues to undermine efforts to address critical needs across Yemen. The 2024 Humanitarian Response Plan sought US$2.7 billion to reach 11.2 million people in desperate need across the country. As of December 27, the HRP is only 50 percent funded.