Global cholera vaccination moves beyond outbreak response

Rising global vaccine supply allows resumption of preventive campaigns after a three-year pause

KARACHI: Global efforts to prevent cholera have entered a new phase as international health agencies approved the resumption of preventive oral cholera vaccination campaigns after a pause of more than three years, with Mozambique becoming the first country to restart the programme after receiving 3.6 million doses of the vaccine.

According to a joint announcement by the World Health Organization (WHO), Gavi, the Vaccine Alliance, and UNICEF, annual global production of oral cholera vaccine (OCV) has nearly doubled — from 35 million doses in 2022 to almost 70 million doses in 2025 — easing shortages that had forced health authorities worldwide to largely restrict vaccination to outbreak response. The vaccines are financed by Gavi and procured and delivered by UNICEF through the global stockpile.

A first allocation of 20 million doses has been approved for preventive campaigns in three high-risk countries. Of these, around 3.6 million doses have been delivered to Mozambique, which is battling an ongoing cholera outbreak amid the aftermath of floods that displaced more than 700,000 people and damaged water and sanitation systems. The Democratic Republic of the Congo has received about 6.1 million doses, while more than 10 million doses are planned for delivery to Bangladesh, both of which continue to face significant cholera risks.

WHO said the restoration of preventive vaccination has been made possible by sustained efforts by manufacturers and global partners to expand production capacity and streamline allocation mechanisms, ensuring limited supplies reach areas where the public health impact is greatest.

WHO Director-General Dr Tedros Adhanom Ghebreyesus said prolonged global vaccine shortages had forced health authorities into a reactive cycle. “We are now in a stronger position to break that cycle,” he said, noting that expanded production had made preventive vaccination possible again and urging additional manufacturers to enter the cholera vaccine market.

Gavi Chief Executive Officer Dr Sania Nishtar said the surge in cholera cases in recent years was a stark reminder that sustainable and accessible vaccine supply is a global public good. She added that donor support and collaboration with manufacturers had been critical in restoring preventive campaigns and maintaining the global OCV stockpile.

UNICEF Executive Director Catherine Russell said the increased supply would, for the first time in years, allow countries to better prevent large-scale cholera emergencies. She stressed, however, that vaccination must go hand in hand with improved access to safe water, sanitation and hygiene to effectively curb transmission.

The three recipient countries were selected under allocation criteria developed by the Global Task Force for Cholera Control (GTFCC), a partnership of more than 50 organisations, to ensure preventive vaccines are distributed systematically, equitably and transparently based on public health risk.

Cholera, a waterborne disease that causes severe diarrhoea and dehydration, continues to pose a major global threat, particularly in areas affected by poverty, conflict and weak water infrastructure. More than 600,000 cases of cholera or acute watery diarrhoea and nearly 7,600 deaths were reported from 33 countries last year, though experts say the true burden is likely higher.

While vaccine availability is improving, WHO said long-term investments in water and sanitation infrastructure, disease surveillance and rapid treatment remain essential to reduce deaths and prevent future outbreaks.

n  IV News Desk

Photos courtesy: WHO


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