Preventive cholera vaccination programs will restart globally after nearly four years of pause tied to a vaccine shortage, the World Health Organization said Feb. 4, resuming efforts that had been limited largely to emergency use during outbreaks. In a joint statement, WHO, the vaccine alliance Gavi and UNICEF said stocks in the global oral cholera vaccine stockpile they manage had improved to nearly 70 million doses last year, allowing the program restart.
WHO said the shortage that began in 2022 forced countries to shift away from preventive campaigns and rely on vaccines mainly in response to outbreaks. It said the stockpile fell to 35 million doses during that period, while countries facing outbreaks requested far more doses than were available.
The organizations said the restart includes an initial deployment of 20 million doses. They said 3.6 million doses are going to Mozambique, 6.1 million to Congo, and 10.3 million are planned for delivery to Bangladesh.
In the statement, WHO Director-General Tedros Adhanom Ghebreyesus said global vaccine shortages had forced health systems into “a cycle of reacting to cholera outbreaks instead of preventing them,” and that WHO is “now in a stronger position to break that cycle.”
WHO described cholera as a diarrheal disease caused by waterborne bacteria, with outbreaks often occurring when water supplies are unsafe and sanitation is disrupted. It said poverty, conflict and climate crises can contribute, particularly when health facilities are destroyed and access to clean water is disrupted, or when floods spread the bacteria.
WHO said Mozambique is one of the priority countries after devastating flooding in the southern African nation last month affected around 700,000 people and increased the threat of cholera outbreaks. The agency previously said poverty and conflict remain enduring drivers of cholera worldwide and that climate change aggravated an upsurge that began in 2021 by contributing to more and wetter storms.
The WHO statement also said the vaccine shortage prompted a shift to a one-dose strategy rather than the previously used two-dose approach. It said a one-dose strategy would remain standard, with two-dose campaigns considered on a case-by-case basis.
WHO said more than 600,000 cholera cases and nearly 7,600 deaths were reported to the agency last year. It said global cholera cases rose year after year from 2021 before declining in 2025, while cholera-related deaths continued to rise.