Global Cholera Vaccine Supply Surges, Enabling Resumption of Preventive Campaigns

The global supply of oral cholera vaccines (OCV) has significantly increased, enabling the resumption of preventive vaccination campaigns after a three-year pause. This crucial development was jointly announced by Gavi, the Vaccine Alliance, UNICEF, and the World Health Organization (WHO). The improved supply addresses years of shortages, which were caused by a worldwide surge in cholera cases and had necessitated a focus on emergency responses rather than proactive prevention.

Campaign Resumption and Initial Allocations

Mozambique is the first country to restart preventive vaccination efforts. This initiative comes amidst an ongoing cholera outbreak in the country and the devastating aftermath of recent floods, which affected over 700,000 people, severely disrupted health systems, and damaged vital water infrastructure, thereby increasing the risk of waterborne diseases.

An initial allocation of 20 million doses is now being deployed for these preventive campaigns. Specific distributions include:

• 3.6 million doses to Mozambique.
• 6.1 million doses to the Democratic Republic of the Congo, which is also battling ongoing outbreaks.
• 10.3 million doses planned for delivery to Bangladesh.

The countries selected for this initial allocation were chosen based on criteria established by the Global Task Force for Cholera Control (GTFCC). The GTFCC is a coalition responsible for ensuring the systematic, equitable, and transparent distribution of vaccines.

Dr. Ilesh Jani, chair of the GTFCC Steering Committee, emphasized that "preventive vaccination provides protection and time," while also noting that long-term investment in infrastructure and sustained political commitment are essential for lasting progress.

Supply Projections and Partner Contributions

The annual global OCV supply is projected to nearly double from 35 million doses in 2022 to almost 70 million doses in 2025. This significant increase is attributed to expanded production capabilities and enhanced coordination among various partners. EUBiologics was specifically recognized for its considerable production efforts.

Gavi plays a pivotal role by financing these vaccine doses, while UNICEF is responsible for their procurement and subsequent delivery to countries in need.

Dr. Sania Nishtar, CEO of Gavi, described a sustainable vaccine supply as a "global public good," crediting strong partnerships and robust donor support for the recent advancements.

Catherine Russell, UNICEF Executive Director, stated that the increased vaccine supply "would assist in preventing large-scale cholera emergencies and protecting children, while also requiring improved access to safe water and basic sanitation."

WHO Director-General Dr. Tedros Adhanom Ghebreyesus highlighted that global vaccine shortages had previously forced a reactive approach to cholera outbreaks, rather than enabling prevention. He indicated that this latest development significantly strengthens the ability to "break the cycle of reacting to outbreaks."

Understanding Cholera and Comprehensive Response

What is Cholera?

Cholera is an acute diarrheal illness caused by infection of the intestine with Vibrio cholerae bacteria. It is primarily spread through contaminated food and water. The disease causes severe diarrhea and dehydration and can be fatal without prompt treatment. It is particularly prevalent in areas lacking safe water and adequate sanitation, especially those affected by conflict and poverty.

The Oral Cholera Vaccine (OCV)

The oral cholera vaccine is considered safe and effective for individuals over one year of age. A single dose provides short-term protection for at least six months, proving effective in controlling outbreaks. Two doses offer longer protection, lasting up to three years. While the global supply of OCV is improving, the one-dose strategy remains standard for rapid outbreak responses, with two doses considered on a case-by-case basis depending on the specific context and risk.

Global Cholera Landscape

In 2023, over 600,000 cases of cholera or acute watery diarrhea and nearly 7,600 deaths were reported to the WHO from 33 countries; these figures are widely considered underestimates due to surveillance limitations. Global cholera cases had increased annually since 2021, with a projected decline in 2025 for cases, though the number of deaths has continued to rise. Notably, cases reportedly decreased in 2024.

Beyond Vaccination: A Holistic Approach

Vaccination, while critical, is only one component of a comprehensive strategy for cholera prevention and response. Long-term investments in safe water, sanitation, and hygiene (WASH) infrastructure are paramount. These efforts must be complemented by robust disease surveillance, rapid treatment protocols, and active community engagement to effectively prevent outbreaks and significantly reduce mortality.