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 1.3–4 million cases and 21,000–143,000 deaths worldwide due to cholera each year. The majority of cases reported to WHO are outbreak-related, with 40–50 confirmed outbreaks every year. Yet 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 are among the poorest populations who do not have rapid access to health services.

There are three main situations where cholera thrives:1 

  • endemic conditions: where the disease is entrenched in communities. This is the case, for example, in regions of the Democratic Republic of Congo and Bangladesh. In Bangladesh there are an estimated 300,000 cases and 4,500 deaths each year. 
  • sudden outbreaks: where instant vaccination is most effective, such as in Guinea and Malawi.
  • during humanitarian crises: such as the late 2013 outbreak in South Sudan. 

Up to 80% of all cholera cases can be successfully treated with oral rehydration salts. Outbreaks and deaths occur because people cannot access adequate treatment.


In 2013, the oral cholera vaccine was distributed to thousands of displaced people who had found shelter in makeshift camps at United Nations sites in South Sudan. This almost certainly prevented increased illness and death amongst the vulnerable camp inhabitants, who were at high risk of being infected.

1WHO. Cholera risks high across world, but deadly disease can be controlled. Available at: www.who.int/cholera/publications/6July2015/en/. Accessed on: 15 August 2016. Feasibility and effectiveness of oral cholera vaccine in an urban endemic setting in Bangladesh: a cluster randomised open-label trial. Lancet, 2015. Ali, M, Lopez, AL, You, Y et al. The global burden of cholera. Bull World Health Organ. 2012; 90: 209–218. 


Global stockpile has vaccinated over 2 million people

Cholera vaccine stockpile prevents outbreaks

The global oral cholera vaccine (OCV) stockpile was founded in mid-2013 by five donors.

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

Since its creation, the stockpile has been used to vaccinate more than two million people. It is managed by the International Coordinating Group, which includes four Alliance partners: the International Federation of Red Cross and Red Crescent Societies, Médecins Sans Frontières, UNICEF and WHO.

The objectives of our investment are:

  1. breaking the current cycle of low demand–low supply of oral cholera vaccine;
  2. reducing outbreaks in Gavi-supported countries; and
  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, run by Médecins Sans Frontières, vaccinated the Minawao and Gawar refugee camps, as well as the nearby villages of Gadala and Gawar.

Eight countries – the Democratic Republic of the Congo, Haiti, Mozambique, Malawi, Niger, Somalia, South Sudan and Zambia – accessed the stockpile in 2016.

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