by Burden of Cholera Around the World
Cholera remains a major public health threat in many developing countries across Asia, Africa, and Latin America. It is an acute diarrheal infection caused by the bacterium Vibrio cholerae. Those infected can suffer from severe watery diarrhea, vomiting, and dehydration. If left untreated, cholera can kill within hours.
According to the World Health Organization (WHO), there are an estimated 1.3 to 4 million cases of cholera and 21,000 to 143,000 deaths worldwide every year. The global burden is increasing with multiple countries experiencing recurrent outbreaks and with epidemic hotspots in places like Yemen, Congo, Mozambique, and Haiti. Cholera thrives in areas with inadequate access to safe water and sanitation and spreads rapidly in densely populated regions. Climate change is also contributing to the worsening of cholera outbreaks with rising sea surface temperatures and extreme weather events linked to increased transmission.
Cholera Vaccines Industry as a Critical Tool for Cholera Control and Elimination
Oral Cholera Vaccines are a proven, cost-effective tool that can help control and eliminate cholera when combined with other public health interventions like improved water, sanitation, and hygiene. Three WHO prequalified oral cholera vaccines are currently available – Dukoral, Shanchol, and Euvichol. Vaccines stimulate the body’s natural defenses to fight off infections if exposed to cholera bacteria in the future.
Trials have shown that a single dose of Shanchol or two doses of Dukoral provide around 60-85% protection for at least 3 years against infection. WHO recommends the use of cholera vaccines for both reactive campaigns in outbreak settings as well as for prevention of future outbreaks. Vaccines have helped eliminate cholera transmission in some regions like latin american countries. However, limited global supply and unequal access continue to hamper the scale up of vaccine programs worldwide.
Progress Towards Increased Production and Supply
There have been positive developments in recent years to expand Cholera Vaccines supply and ensure sustained production to meet growing demand. The two leading producers – Shantha Biotechnics and International Vaccine Institute (IVI) – have both increased production capacity. IVI has successfully transferred the modern production process of the vaccine from oral liquid to lyophilized powder form making transport and delivery much easier.
With financial support from Gavi, the Vaccine Alliance, an additional 1 million doses of Shanchol are available every year since 2018 for cholera control in Gavi-eligible countries. This helps address supply constraints and ensures long-term affordable access. In 2021, Emergent BioSolutions also received an approva from the US Food and Drug Administration (FDA) to produce Shanchol doses in the US. If commercialized, this could further boost global supply.
Despite these gains, current production still falls short of estimated global demand which is 5-10 times more than current supply. Securing long term manufacturing partnerships and investments are critical to build sufficient stockspile of vaccines for emergency response and routine immunization programs in cholera hotspots. Unless supply issues are resolved, millions will continue to lack protection from this deadly but preventable disease.
Policy Recommendations to Maximize Impact of Cholera Vaccines Industry
While vaccines are an invaluable tool, their effectiveness depends greatly on policies adopted by countries and support from international agencies. Some key recommendations include:
– All cholera-endemic countries should incorporate oral cholera vaccination into their routine immunization programs for high-risk groups like children and fisherfolk living in hotspots.
– Major public health agencies and donors need to prioritize cholera control by significantly scaling up investments in vaccine procurement and availability through coordinated arrangements with manufacturers as well as advanced purchase agreements.
– A global cholera vaccine stockpile managed by WHO must be established to enable timely emergency responses during outbreaks and ensure no one is left behind due to an inability to pay.
– Countries have to strengthen epidemiological and laboratory surveillance so accurate data can guide rational vaccine deployment. Cross-border coordination is critical where cholera transmission occurs across regions.
– Behavior change campaigns emphasizing hand washing, safe water handling, and improved sanitation practices need to complement vaccination to maximize impact on cholera transmission reduction.
With concerted global action on these fronts, the collective aim should be to integrate cholera control into universal health coverage agenda and work towards a world free from cholera. Oral vaccines offer the most practical hope to curb this ancient scourge if strategically delivered at scale to at-risk communities worldwide.
Addressing vaccine supply constraints and developing coordinated vaccine policies, it is possible to significantly reduce cholera deaths to below 10,000 annually by 2030 as envisioned in the Global Roadmap to 2030. Saving millions of lives from this preventable disease necessitates urgent and sustained collaborative efforts. The coming years will be crucial to leverage the full potential of these lifesaving tools.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
