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Background: The Initiative against Diarrheal and Enteric Diseases in Africa and Asia (IDEA) was launched to play a significant and sustainable role in the understanding, prevention and control of enteric diseases. Its initial focus is on cholera, a disease responsible for large-scale epidemics resulting in high morbidity and mortality rates., Study Design: We present an update on the evolution of cholera from 2004 to 2013 based on data provided by experts from four IDEA African countries: Benin, Cameroon, the Democratic Republic of Congo and Mali., Results: Cholera has been responsible for severe epidemics with high fatality rates in Africa over the recent years. The 2013 data are the most recent data on cholera available for the four countries. While some signs of improvement are visible, not all countries have experienced a declining trend in the occurrence of the disease., Conclusion: Cholera remains a public health issue in Africa with a risk of potential recurrent outbreaks. The multifactorial nature of the disease requires a multi-sectorial approach combining several complementary operational strategies. The most critical challenges include achieving a more consistent and reliable reporting of cases and a better appraisal of the real burden of the disease through a better cholera case definition. Ongoing efforts must be supported and renewed to provide improved and sustained access to safe drinking water and sanitation and raise disease awareness further. Investing in operational research for a better understanding of the spatio-temporal dynamics of cholera will also help adapt the control strategies against the disease.