Cholera Vaccination Resumes as Global Supply Hits Milestone

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.

Mozambique is the first country to resume preventive vaccination after the pause in 2022, which was triggered by a global increase in cholera cases that heightened demand and resulted in shortages of oral cholera vaccine (OCV) supplies.

The preventive vaccination campaign begins amid an ongoing cholera outbreak and the aftermath of floods that affected more than 700,000 people and displaced many. The floods disrupted health systems and damaged water systems, further increasing the risk of waterborne diseases such as cholera.

"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. I thank EUBiologics, currently the only manufacturer producing cholera vaccines at the scale needed for mass vaccination campaigns, for its efforts, and urge others to enter this vital space. These vaccines will save lives," said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.

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.

Following sustained efforts by global agencies, manufacturers, and partners, the annual global supply of Oral Cholera Vaccine (OCV) has doubled from 35 million doses in 2022 to nearly 70 million doses in 2025. The doses are being financed by Gavi, while UNICEF is responsible for procuring and delivering them to countries.

"The multi-year surge in cholera cases and the resulting unprecedented demand for vaccines serve as stark reminders that a sustainable and accessible vaccine supply is a global public good—one that the world cannot afford to take for granted," stated Dr. Sania Nishtar, CEO of Gavi, the Vaccine Alliance. "We are thankful to our partners and manufacturers, especially EUBiologics, for their collaboration, which has allowed us to resume these essential preventive campaigns, and to Gavi's donors, whose support makes it possible for us to finance the global OCV stockpile and conduct life-saving outbreak and preventive initiatives."

"For the first time in years, this increase in vaccines will allow us to better prevent large-scale cholera emergencies," said Catherine Russell, UNICEF Executive Director. "Resuming preventive cholera vaccination will protect children and help stop this highly contagious disease in its tracks. But it must go hand in hand with other efforts, including better access to safe water and basic sanitation."

The three countries were selected according to the allocation criteria established by the Global Task Force for Cholera Control (GTFCC), a coalition of more than 50 organizations, aiming to ensure that cholera vaccines for preventive campaigns are distributed in a systematic, equitable, and transparent manner.

"This milestone shows the power of bringing together diverse partners to build a more reliable response to cholera. Preventive vaccination helps shield communities and buys critical time. However, lasting progress will depend on long-term investment in infrastructure, for which political commitment is indispensable," said Dr. Ilesh Jani, chair of the Steering Committee of the GTFCC.

The restoration of preventive vaccination has been achieved through years of dedicated efforts and strong collaboration among agencies, manufacturers, and other partners. This cooperation aims to address the ongoing high demand in response to outbreaks, enhance production capacity, and optimize distribution, ensuring that limited supplies are directed to areas with the greatest risk and public health impact.

The OCV is safe and effective and is recommended for individuals over 1 year of age. One dose of OCV offers short-term protection for at least 6 months and can assist in controlling outbreaks, while two doses extend protection against infection for a longer period—up to 3 years.

While global vaccine supply steadily improves, the one-dose strategy will continue to be the standard for outbreak responses, with the administration of two doses evaluated on a case-by-case basis.

Cholera spreads through contaminated food and water, leading to severe diarrhea and dehydration. If not treated promptly, it can result in death. The disease is prevalent in areas lacking safe water and sanitation, particularly in regions impacted by conflict and poverty.

More than 600,000 cases of cholera or acute watery diarrhea and nearly 7,600 deaths were reported to the WHO from 33 countries last year, although these numbers are likely underestimates as cholera is often underreported. Since 2021, global cholera cases have risen each year, with a decline noted in 2025. However, deaths from cholera have continued to rise during the same period.

Vaccination is only one aspect of cholera prevention and response. Long-term investments in safe water, sanitation, and hygiene infrastructure, along with disease surveillance, rapid treatment, and community engagement, are crucial to prevent outbreaks from starting and spreading, and to reduce deaths in the long run.

Gavi, the Vaccine Alliance is a public-private partnership that assists in vaccinating over half of the world's children against some of the deadliest diseases. The Vaccine Alliance unites governments from developing countries and donor nations, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Gates Foundation, and other private sector partners.

Since its inception in 2000, Gavi has helped to immunize an entire generation—over 1.2 billion children—and has prevented more than 20.6 million future deaths, contributing to a halving of child mortality in 78 lower-income countries. Gavi also plays a crucial role in enhancing global health security by supporting health systems and funding global stockpiles for vaccines against Ebola, cholera, meningococcal disease, and yellow fever.

UNICEF, the United Nations agency dedicated to children, strives to safeguard the rights of every child, everywhere, with a particular focus on the most disadvantaged and those in the most challenging circumstances. Operating in over 190 countries and territories, we commit to doing whatever is necessary to ensure that children not only survive but also thrive and realize their full potential.