Table of Contents  
LETTER TO THE EDITOR
Year : 2016  |  Volume : 9  |  Issue : 6  |  Page : 774-775  

Addressing the issue of shortage of oral cholera vaccines on the global front


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Date of Web Publication16-Nov-2016

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, 3rd Floor, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.194236

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Addressing the issue of shortage of oral cholera vaccines on the global front. Med J DY Patil Univ 2016;9:774-5

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Addressing the issue of shortage of oral cholera vaccines on the global front. Med J DY Patil Univ [serial online] 2016 [cited 2024 Mar 28];9:774-5. Available from: https://journals.lww.com/mjdy/pages/default.aspx/text.asp?2016/9/6/774/194236

Sir,

Cholera is an acute diarrheal disease which is fatal if not treated promptly. [1] The global estimates suggest that almost 4.3 million cholera cases and up to 0.14 million deaths have been reported each year worldwide. [1] This is a seriously alarming figure as close to four-fifth of the cholera cases can be successfully managed by administration of oral rehydration salts alone. [1] China, India, and Indonesia have been identified as three of the most endemic nations accounting for maximum number of cholera cases while Bangladesh and India account for the largest at-risk population in the Asian region. [2] Even though, maintenance of safe water and sanitation is the crucial link, oral cholera vaccines (OCVs) remain a supplementary tool to prevent the disease. [1]

In fact, two forms of OCVs have been used across the world in various mass vaccination campaigns. [1],[3] The subsequent analysis of the OCV campaign has revealed immense utility in the protection of the high-risk population. [2],[3] However, it has been acknowledged that OCV production is low, with demands currently exceeding supply owing to which various vaccination campaigns could not be organized in the affected nations. [3] This is despite of the establishment of an OCV stockpile of millions of doses required for the containment of the outbreak and even emergencies, to supplement the activities directed to improve water and sanitation. [1]

The deficiency in the supply of OCVs is predominantly because of the nature of the disease which extensively affects poor sections of the society who are more often than not unaware about the existence of an effective vaccine, and thus have never demanded for the same, and due to the lack of political priority by the government stakeholders despite the disease still being endemic in more than 50 nations. [1],[4]

To address the issue of shortage of OCV, the World Health Organization has allowed a new vaccine manufacturer for the production of quality-assured vaccines. [3] It has been anticipated that the global supply of OCV will be doubled to 6 million for the year 2016, and thus concerns of global shortage and inaccessibility to vaccines can be addressed. [3] This augmented capacity of vaccine production will play a significant role in the reversal of the vicious cycle of lesser demand, lesser production, higher cost, and inequitable distribution. [2],[3],[4]

Furthermore, to work toward improving the access to OCV, separate funds have been allocated by the Global Alliance for Vaccines Initiative, especially to expand the availability and the use of the vaccine in nations with endemic cholera. [1],[3] In addition, mathematical models have been developed to ensure optimal allocation of vaccines (viz., where, when, and how many doses) in heterogeneous settings based on the demographic and incidence of cholera cases. [5]

To conclude, the concern of shortage of OCV needs immediate attention from the international stakeholders, and thus, approval of its production by another agency is a major success for the stakeholders as this step can significantly improve the health standards of millions of people.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
World Health Organization. Cholera - Fact Sheet No. 107; 2015. Available from: http://www.who.int/mediacentre/factsheets/fs107/en/. [Last accessed on 2016 Jan 05].  Back to cited text no. 1
    
2.
Ali M, Nelson AR, Lopez AL, Sack DA. Updated global burden of cholera in endemic countries. PLoS Negl Trop Dis 2015;9:e0003832.  Back to cited text no. 2
    
3.
World Health Organization. Cholera Vaccine Supply Set to Double, Easing Global Shortage; 2015. Available from: http://www.who.int/cholera/vaccines/double/en/. [Last accessed on 2016 Jan 08].  Back to cited text no. 3
    
4.
Tohme RA, François J, Wannemuehler K, Iyengar P, Dismer A, Adrien P, et al. Oral cholera vaccine coverage, barriers to vaccination, and adverse events following vaccination, Haiti, 2013(1). Emerg Infect Dis 2015;21:984-91.  Back to cited text no. 4
    
5.
Smalley HK, Keskinocak P, Swann J, Hinman A. Optimized oral cholera vaccine distribution strategies to minimize disease incidence: A mixed integer programming model and analysis of a Bangladesh scenario. Vaccine 2015;33: 6218-23.  Back to cited text no. 5
    




 

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