Millions are at risk from cholera due to a lack of clean water, soap, and toilets, and a shortage of cholera vaccine, a study by the International Coordinating Group (ICG) on Vaccine Provision has revealed.
The International Coordinating Group (ICG) is a group that manages the global cholera vaccine stockpile.
A statement released by the World Health Organization highlighted the immediate actions needed to be undertaken, by countries to control the upsurge in cholera cases worldwide as the International Coordinating Group (ICG) on Vaccine Provision study has brought to the limelight.
“The actions include investing in access to safe water, sanitation and hygiene, testing and detecting outbreaks quickly, improving the quality of and access to healthcare, and fast-tracking additional production of affordable oral cholera vaccine (OCV) doses to better prevent cases”.
The report revealed that “Cholera has been surging globally since 2021, with the 473,000 cases reported to WHO in 2022, more than double those reported in 2021. Preliminary data for 2023 reveal further increases, with over 700,000 cases reported. Several of the outbreaks have high case fatality rates, exceeding the 1% threshold used as an indicator for early and adequate treatment of cholera patients. These trends are tragic given that cholera is a preventable and treatable disease and that cases had been declining in previous years”.
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Cholera is an acute intestinal infection that spreads through food and water contaminated with feces containing the bacterium Vibrio cholerae.
Persistent gaps in access to safe water and sanitation are driving the rise in cholera. Although efforts are being made to close these gaps in places, in many others the gaps are growing, driven by climate-related factors, economic insecurity, conflict, and population displacement. Safely managed water and sanitation are prerequisites for stopping the transmission of cholera.
Currently, the most severely impacted countries include the Democratic Republic of the Congo, Ethiopia, Haiti, Somalia, Sudan, Syria, Zambia, and Zimbabwe.
The group called on countries to find realistic methods to combat cholera outbreaks.
“Now more than ever, countries must adopt a multisectoral response to fight cholera. Members of the ICG call on currently and potentially affected countries to take urgent steps to ensure their populations have access to clean water, hygiene and sanitation services, and the information critical to preventing cholera’s spread.
“The establishment of these services requires political will and investment at the country level. This includes creating capacity for early detection and response, enhanced disease detection, rapid access to treatment and care, and working closely with communities, including on risk communication and community engagement”.
The report, in the statement released by WHO, indicated that “The severe gap in the number of available vaccine doses, compared with the level of current need, puts unprecedented pressure on the global stockpile of vaccines. Between 2021 and 2023, more doses were requested for outbreak response than in the entire previous decade.
“In October 2022, the ongoing vaccine shortage necessitated the ICG to recommend a single vaccine dose, down from a previous, long-standing two-dose regimen. Approximately 36 million doses were produced last year, while 14 affected countries registered a need for 72 million doses for a one-dose reactive strategy.
“These requests understate the true need. Preventive vaccination campaigns have had to be delayed to preserve doses for emergency outbreak control efforts, creating a vicious cycle. The change in strategy enabled available vaccines to protect more people and respond to more cholera outbreaks amid the ongoing supply shortfall, but a return to a two-dose regimen and a resumption of preventive vaccination would provide longer protection”.
It added that “Global production capacity in 2024 is forecast to be 37-50 million doses but will likely continue to be inadequate to serve the needs of millions of people directly affected by cholera. Only one manufacturer, EuBiologics, currently produces the vaccine; while the company is doing its utmost to maximize output, more doses are needed. Currently, new manufacturers are not expected to join the market before 2025; they must be fast-tracked. The same urgency and innovation that we saw for COVID-19 must be applied to cholera”.
ICG members, which include, the International Federation of Red Cross and Red Crescent Societies, Médecins Sans Frontières, UNICEF, and WHO. Gavi, the Vaccine Alliance, finances the vaccine stockpile and the delivery of OCV further called on governments, donors, vaccine manufacturers, partners, and communities to join in an urgent effort to halt and reverse the rise in cholera globally.
Additionally, the group called on manufacturers planning to enter the market to accelerate their efforts and make doses for cholera treatment available at affordable prices.