We’re Making Progress in the Global Effort to End Cholera

A child in Sierra Leone receives the oral cholera vaccine, which will protect her for up to three years for less than six dollars | Photo credit: WHO/Acland

Earlier this year, I shared a look at why 2018 was off to an encouraging start with the advent of two game-changing developments in the vaccine space: The world’s first typhoid vaccine for infants was pre-approved for use, and a repackaged version of one of the world’s most important cholera vaccines made it to the field.

Bringing cholera vaccines to the field has been of particular importance in recent years, as cholera outbreaks have swept the globe — from Haiti and Yemen to Zambia and Somalia — with no signs of abating. It continues to disproportionately affect the world’s most marginalized and impoverished people at a scale that is staggering — up to 4 million cases and 100,000 deaths occur every year. While major investments in improved water and sanitation systems are necessary to address the underlying causes of cholera in the long term, oral cholera vaccines are essential to protecting communities most at risk in the short-term by preventing and controlling outbreaks.

The good news is we’ve seen success from oral cholera vaccines in helping to control recent outbreaks in South Sudan, Zambia, and Malawi, as well as in preventing an outbreak among Rohingya refugees in Bangladesh thanks to rapid deployments by the World Health Organization (WHO) and Gavi, the Vaccine Alliance. Two recent innovations in vaccine technology will make it easier to get cholera vaccines to the people who need them most: Last fall, the WHO prequalified Euvichol-Plus, a novel packaging of oral cholera vaccine that is cheaper, smaller, and lighter than previous versions, which will help health workers quickly get more vaccines to people in need. In February this year, Shanchol — another oral cholera vaccine — received approval from the WHO for use at temperatures as high as 40°C for up to 14 days. This is significant because it can alleviate some of the challenges of maintaining the cold chain that keeps vaccines viable in hot environments where cholera vaccines are desperately needed.

Oral cholera vaccines are a game changer because they work to prevent cholera for up to three years, effectively bridging emergency response and longer-term cholera control measures. With the global stockpile anticipated to increase to 25 million doses this year (compared to seven million in 2016), these vaccines will play a vital role in achieving the ambitious goals set forth in The Global Taskforce on Cholera Control’s Global Roadmap to End Cholera last October, which include reducing cholera deaths by 90 percent by 2030.

As we close World Immunization Week 2018, I want to commend The Global Taskforce on Cholera Control for its integrated, targeted, and phased approach to stop cholera, and call on partners and countries around the world to support the Global Roadmap. To tackle cholera once and for all, we must take a proactive, multi-sector approach to the fight — from the use of oral cholera vaccines now to the implementation of basic water, sanitation, and hygiene services in the future — so we can effectively prevent cholera outbreaks. It is only through this shared commitment that we can lay the groundwork for finally eliminating cholera as a serious global health challenge.

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