Global cholera vaccine supply has now increased to a level sufficient to allow the resumption of life-saving preventive campaigns for the first time in over three years, Gavi, the Vaccine Alliance, UNICEF, and the World Health Organization (WHO) announced today. This marks a significant step forward in the fight against cholera, a disease that has seen a troubling rise in cases worldwide.
Mozambique is the first country to restart preventive vaccination, following a halt in 2022 caused by a global surge in cholera cases that drove up demand and led to shortages of oral cholera vaccine (OCV) stocks. The campaign begins amid an ongoing cholera outbreak and the aftermath of floods that affected more than 700,000 people and displaced many. These floods disrupted health systems and damaged water systems, further increasing the risk of waterborne diseases such as cholera.
Resuming Preventive Vaccination
The announcement comes as a relief to global health organizations that have been grappling with the challenges of vaccine shortages. “Global vaccine shortages forced us into a cycle of reacting to cholera outbreaks instead of preventing them. We are now in a stronger position to break that cycle,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. He acknowledged the efforts of EUBiologics, currently the only manufacturer producing cholera vaccines at the scale needed for mass vaccination campaigns, and urged others to enter this vital space.
A first allocation of 20 million doses is being deployed for preventive campaigns. Of these, 3.6 million doses were delivered to Mozambique; 6.1 million to the Democratic Republic of the Congo, which is also experiencing significant outbreaks; and 10.3 million doses are planned for delivery to Bangladesh.
Global Supply and Strategic Allocation
Following sustained efforts by global agencies, manufacturers, and partners, the annual global supply of OCV has doubled from 35 million doses in 2022 to nearly 70 million doses in 2025. The doses are being financed by Gavi and procured and delivered to countries by UNICEF.
“The multi-year surge in cholera cases and resulting unprecedented demand for vaccines were stark reminders that sustainable, accessible vaccine supply is a global public good – and the world cannot afford complacency,” said Dr. Sania Nishtar, CEO of Gavi, the Vaccine Alliance. She expressed gratitude to partners and manufacturers for their collaboration, which has made the resumption of these essential preventive campaigns possible.
For the first time in years, this increase in vaccines will allow better prevention of large-scale cholera emergencies. “Resuming preventive cholera vaccination will protect children and help stop this highly contagious disease in its tracks,” said Catherine Russell, UNICEF Executive Director. She emphasized that vaccination must go hand in hand with efforts to improve access to safe water and basic sanitation.
Strategic Distribution and Future Challenges
The three countries receiving the initial vaccine allocations were chosen based on criteria set by the Global Task Force for Cholera Control (GTFCC), a partnership of over 50 organizations. This ensures that cholera vaccines for preventive campaigns are distributed systematically, equitably, and transparently.
“This milestone shows the power of bringing together diverse partners to build a more reliable response to cholera,” said Dr. Ilesh Jani, chair of the Steering Committee of the GTFCC. He noted that while preventive vaccination helps shield communities and buys critical time, lasting progress will depend on long-term investment in infrastructure, for which political commitment is indispensable.
The restoration of preventive vaccination has been made possible by years of sustained efforts and close collaboration among agencies, manufacturers, and other partners. These efforts aim to meet the continued high demand to respond to outbreaks, expand production capacity, and streamline allocation, ensuring that limited supplies reach the places where the risk and public health impact are greatest.
Cholera: A Continuing Global Challenge
Cholera spreads through contaminated food and water, causing severe diarrhea and dehydration. It can lead to death if not treated quickly. The disease is prevalent in areas lacking safe water and sanitation, mainly in regions affected by conflict and poverty.
More than 600,000 cases of cholera or acute watery diarrhea and nearly 7,600 deaths were reported to WHO from 33 countries last year, although these figures are likely underestimates as cholera remains underreported.
Since 2021, global cholera cases have risen year after year, with a decline observed in 2025. However, cholera deaths have continued to increase over the same period. Vaccination is only one aspect of cholera prevention and response. Long-term investments in safe water, sanitation, and hygiene infrastructure, alongside disease surveillance, rapid treatment, and community engagement, remain essential to prevent outbreaks from starting and spreading, and to reduce deaths in the long term.
While global vaccine supply steadily improves, the one-dose strategy will remain the standard for outbreak responses, with the use of two doses considered on a case-by-case basis. The OCV is safe and effective, recommended for individuals over one year of age. One dose provides short-term protection for at least six months, while two doses offer longer protection for up to three years.
As the world works to overcome the challenges posed by cholera, the resumption of preventive vaccination campaigns represents a crucial step in controlling this deadly disease. However, the success of these efforts will depend on sustained global cooperation and investment.
