Multi-year Planning for Oral Cholera Vaccines Needed to Inform Global Vaccine Supply and Help Prevent Deadly Outbreaks

Updated June 27, 2022

Without appropriate treatment, about 1 in 10 people with cholera will develop life-threatening symptoms that can lead to death within hours. Around 1.3 billion people are at risk of cholera worldwide, disproportionally affecting communities in low- and middle-income countries.

Oral cholera vaccines (OCV) can reduce cholera-related illness and death in these communities, but countries face barriers to access and deliver OCV to protect health and save lives, including lengthy applications and campaign quality. To address this, CDC is actively working with countries and Global Task Force for Cholera Control (GTFCC) partners to host interactive in-country trainings to help strengthen country capacity to apply for and use lifesaving OCVs.

Limited Global Stockpile of OCV Challenges Global Cholera Control

The limited supply of OCV, a tool that can be used to both prevent and help control outbreaks, poses a challenge to achieving global cholera control and elimination goals as set out in Ending Cholera: A Global Road Map to 2030.

Countries do not routinely administer OCV. Instead, countries must submit a formal application to request OCV from a global stockpile that was established in 2016 by the World Health Organization (WHO) and other global immunization partners. As more countries prepare to implement OCV preventive campaigns, the demand on the stockpile will increase and likely exceed production capacity. Ongoing large and disruptive cholera outbreaks place additional demand on the OCV stockpile and can delay approved preventive campaigns.

Multi-year planning helps improve vaccine demand forecasting and country access to lifesaving OCV

By developing a multi-year plan of action, countries can move from using OCV as an outbreak response tool to using OCVs to prevent disease and death. These plans will allow better OCV demand forecasting and will inform manufacturing supply, thus increasing the number of doses available to countries in the future.

While global OCV supply remains limited, improving the quality of applications and OCV campaigns will improve timely delivery of vaccines to affected communities and ensure the best use of the available supply.

Six Nation Training Improves Country OCV Applications and Campaign Quality
Pointing at a paper pad, an instructor details factors involved in cholera vaccination systems planning training in Nigeria.

CDC and its Global Task Force for Cholera Control (GTFCC) partners hosted an in-person and virtual interactive training in Abuja, Nigeria in April 2022.

The goals of the training were to:

  • improve OCV applications for both emergency and preventive campaigns.
  • improve preventive and outbreak response campaign quality.
  • support multi-year planning as part of the transition from reactive outbreak response to cholera prevention in the highest risk populations.

Participants included public health professionals from Ministries of Health, WHO Expanded Programme on Immunization (EPI), and WHO Health Emergencies Programmes in Uganda, Ethiopia, Nigeria, Mozambique, Kenya, and South Sudan.

In addition to providing funding, CDC subject matter experts:

  • provided organizational support.
  • presented to attendees and took questions.
  • facilitated breakout sessions.

Dr. E. Osagie Ehanire, MD, FWACS, the Nigerian Minister of Health, provided opening remarks at the training, “I welcome you to this training as a prelude to equitable access to this vaccine, & another step towards our goal of better Health for all." [Source: WHO Nigeria on Twitter]

At the time of the training, many participants were actively working on the development of their countries’ national cholera plans. Other countries were experiencing outbreaks and planned to submit OCV requests. The training provided several practical exercises in each key area, an excellent opportunity for participants to learn from experts and from each other to help create stronger national plans.

CDC-supported Interactive Trainings Help Countries Access and Deliver Lifesaving OCV

As a result of recent interactive trainings, like the multi-country event held in Nigeria (featured above), the GTFCC has seen an improvement in the quality of submitted applications and new applications from countries that have not previously used OCV. Additionally, some countries that attended the event in Nigeria were keen to roll out the training to their sub-national counterparts.

CDC and partners are encouraged by this progress and are offering more trainings at regional and national levels to help overcome vaccine supply challenges and minimize delays in the approval of country applications.

Countries interested in trainings can make a request to the GTFCC at