Cholera Platform

Against cholera

Information on OCV

Oral Cholera Vaccines

Oral cholera vaccines are safe, effective, and acceptable (see Annex A for details on OCV). They present an additional tool for cholera control to supplement, but not to replace, existing priority cholera control measures. With the September 2011 WHO prequalification of a newly manufactured cholera vaccine that is significantly lower in price (50% lower) and simpler to deliver than other cholera vaccines, - it has no need for buffer, has a smaller packed volume and has a vaccine vital monitor (VVM) - there is increased opportunity to use OCV, either pre-emptively or reactively. Furthermore, the International Coordinating Group (ICG) consisting of MSF, IFRC, UNICEF and WHO, is considering the establishment of an OCV stockpile for epidemic response.


UNICEF recommends engagement with governments, WHO and partners to consider OCV use pre-emptively in endemic, at-risk and humanitarian settings and reactively in outbreaks. In all contexts, the decision-making process must be based on a sound risk assessment.


The incidence of cholera is on the rise, with more than 500,000 cases and 7000 deaths reported worldwide in 20112. However, these data are considered a significant underestimate; the actual burden of cholera is estimated to range anywhere from 1.4 million to 4.3 million cases worldwide, resulting in 28,000 to 142,000 deaths per year worldwide, among the 1.4 billion people at risk in endemic countries3. The trends in cholera globally are alarming. There is an increased frequency of large and protracted cholera outbreaks with high mortality, reflecting the weaknesses of existing mechanisms for prevention, early detection, control of spread and access to timely health care. Cholera has become entrenched in more countries in Africa, and it has recently returned to the Americas with ongoing transmission in Haiti and the Dominican Republic. A new strain of Vibrio cholerae, more virulent and causing a more severe clinical illness, emerged in 1992 and has now spread globally4. In addition, climate change and rapid and unplanned urbanization are increasing the pool of already marginalized populations at risk5. Children under five bear the greatest burden of cholera in endemic areas, and account for about half of the estimated cholera deaths6. A marker of inequity, cholera targets the most vulnerable of at risk communities. These populations possess the poorest underlying health status, the least access to essential services such as safe water, sanitation, hygiene, health services and education messages, and they live in the most fragile settings prone to crises and global socio-economic fluctuations.
The 64th World Health Assembly (WHA) in 2011 highlighted this increasingly pressing situation and called for renewed efforts for cholera prevention and control. The WHA urged countries “to undertake planning for and give consideration to the administration of vaccines, where appropriate, in conjunction with other recommended prevention and control methods and not as a substitute for such methods”7.


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