Oral cholera vaccine support

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Cholera is an acute intestinal infection caused by contaminated food or water

The disease can quickly lead to severe dehydration and, in its extreme form, can be fatal

Cholera Cameroon

The oral cholera vaccine is administered at Minawao Camp, Cameroon. Credit: Gavi/2015/Athanas Makundi.

There are an estimated 1.4–4.3 million cases and 28,000–142,000 deaths worldwide due to cholera each year.1 The majority of cases reported to WHO are outbreak-related, with 40–50 confirmed outbreaks every year. However, many cases go unreported.

The disease affects the most vulnerable in urban slums and rural areas, where clean water is not available. Due to the quick progression of the disease, most deaths occur among the poorest populations who do not have rapid access to health services.

There are three main situations where cholera thrives:2 

  • endemic conditions: where the disease is entrenched in communities, such as in regions of the Democratic Republic of Congo and Bangladesh.2 In Bangladesh there are an estimated 300,000 cases and 4,500 deaths each year.3 
  • sudden outbreaks: where an instant vaccination response is deemed most effective, such as in Guinea and Malawi.2 
  • a consequence of humanitarian crisis: such as the late 2013 outbreak in South Sudan.2 

Cholera can be managed effectively with timely rehydration therapy: up to 80% of cases can be successfully treated with oral rehydration salts4. Outbreaks and deaths occur because people cannot access adequate treatment.

DISTRIBUTION OF CHOLERA VACCINE IN SOUTH SUDAN

The oral cholera vaccine was distributed to thousands of displaced people who had found shelter in makeshift camps at United Nations sites. This action almost certainly averted increased illness and death amongst the vulnerable camp inhabitants, who had been at high risk of being infected.


1 WHO Cholera fact sheet, updated July 2015 http://www.who.int/mediacentre/factsheets/fs107/en/ . Accessed on: 13 August 2015.
2 WHO. Cholera risks high across world, but deadly disease can be controlled. Available at: www.who.int/cholera/publications/6July2015/en/. Accessed on: 20 August 2015.
3 Feasibility and effectiveness of oral cholera vaccine in an urban endemic setting in Bangladesh: a cluster randomised open-label trial. Lancet, 2015. Available at: www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)61140-0/fulltext?dialogRequest. Accessed on : 21 August 2015. Ali, M, Lopez, AL, You, Y et al. The global burden of cholera. Bull World Health Organ. 2012; 90: 209–218.
4 WHO Cholera fact sheet, updated July 2015. Available at:  http://www.who.int/mediacentre/factsheets/fs107/en/ Accessed on: 13 August 2015.

  

Global stockpile has vaccinated over 1 million people

Cholera vaccine stockpile prevents outbreaks

The global oral cholera vaccine (OCV) stockpile was founded in mid-2013 by five donors, making two million doses of the vaccine available.

In 2013, the Gavi Board approved support for the OCV stockpile as part of the Vaccine Investment Strategy: a contribution of over US$ 110 million for the period 2014-2018 to increase access to OCV during emergencies and in countries that regularly experience cholera outbreaks.

Since its creation in 2013, the global cholera stockpile has been used to vaccinate over a million people.

The stockpile is managed by the International Coordinating Group, which includes four Alliance partners: International Federation of Red Cross and Red Crescent Societies, Médecins Sans Frontières, UNICEF and WHO.

Gavi’s objectives include:

  1. breaking the current cycle of low demand–low supply
  2. reducing disruptive outbreaks in Gavi-supported countries
  3. strengthening the evidence base for periodic, pre-emptive campaigns.

The first Gavi-supported campaign using the global stockpile began in August 2015 in Cameroon. The campaign, conducted by Médecins Sans Frontières, vaccinated the Minawao and Gawar camps, as well as the nearby villages of Gadala and Gawar.

20 by 2020

Gavi continues to help countries to build sustainable immunisation programmes. Nine countries have already started to fully self-finance all their vaccines introduced with Gavi funding. By the end of 2020, a total of 20 countries are expected to have transitioned out of our support.

Gavi

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