The International Coordinating Group (ICG) on Vaccine Provision has issued a dire warning, urging immediate action to combat an unprecedented surge in cholera cases worldwide. The group, comprising organizations such as the International Federation of Red Cross and Red Crescent Societies, Médecins Sans Frontières, UNICEF, and WHO, has called for a concerted effort to address the root causes of the crisis and ramp up production of the oral cholera vaccine (OCV) to prevent further devastation.

Since 2021, cholera cases have been on the rise globally, with over 473,000 reported to WHO in 2022, more than double the previous year’s count. Preliminary data for 2023 indicate a further increase, surpassing 700,000 cases. Alarmingly, several outbreaks have exhibited high case fatality rates, underscoring the urgent need for intervention.

Cholera, an acute intestinal infection transmitted through contaminated food and water, thrives in environments lacking access to safe water and sanitation. Persistent gaps in these essential services, exacerbated by factors such as climate change, economic instability, conflict, and population displacement, have fueled the current crisis.

The most severely affected countries include the Democratic Republic of the Congo, Ethiopia, Haiti, Somalia, Sudan, Syria, Zambia, and Zimbabwe. Urgent action is imperative to ensure populations in these regions have access to clean water, hygiene, and sanitation services, along with crucial information to prevent cholera transmission.

The shortage of vaccine doses poses a significant challenge, with demand far outstripping supply. The ICG’s recommendation to shift to a single-dose regimen reflects the critical need to maximize vaccine coverage amid limited availability. However, a return to a two-dose regimen and the resumption of preventive vaccination campaigns are essential for long-term protection.

While global production capacity is forecasted to increase in 2024, current levels remain insufficient to meet the needs of affected populations. Urgent measures are required to fast-track additional manufacturers and ensure affordable access to vaccines.

In light of the ongoing cholera crisis, the ICG appeals to vaccine manufacturers, governments, donors, and partners to prioritize the scale-up of vaccine production and invest in comprehensive efforts to prevent and control cholera outbreaks. The same urgency and innovation witnessed during the COVID-19 pandemic must be applied to address this pressing public health emergency.