Cholera Vaccine Shortage

 The manufacturer of one of only two cholera vaccines for use in humanitarian emergencies is to halt production at the end of this year, just as the world faces an “unprecedented” series of deadly outbreaks. 

Shantha Biotechnics, a wholly owned Indian subsidiary of the French pharmaceutical company Sanofi, will stop production of its Shanchol vaccine within months and cease supply by the end of 2023. Shanchol is one of only two oral cholera vaccines suitable for use in a global emergency stockpile used to supply countries battling outbreaks as well as for preventive vaccination campaigns. 

“To say the least, it’s a very disappointing strategy,” Philippe Barboza, the World Health Organization’s team lead for cholera, said. For a disease driven both by an excess and a scarcity of water, climate change had this year exacerbated all the usual causes of cholera, Barboza added. “What is, I would say, unprecedented is the concurrence and succession of massive outbreaks in different parts of the world,” he said.

Although easily treatable, cholera is estimated by the WHO to kill up to 143,000 people annually in the world’s poorest countries, where access to clean water and basic sanitation remains patchy. Countries including Haiti, Syria, Lebanon, Nigeria, Malawi and Ethiopia are fighting outbreaks now. 

While two doses of the oral cholera vaccine only give immunity for around three years in adults, they have come to be seen by health officials as an important tool. Although the long-term solution to cholera remains ensuring access to clean water and good sanitation, “the vaccine is the gamechanger because it allows countries to buy time to implement the rest,” Barboza said.

Of particular concern was the average fatality rate from the disease, which this year, according to the WHO’s data, was almost three times the rate of the past five years.

The increased fatality rate was also “extremely concerning”, he added, particularly as cholera was relatively simple to treat with oral or intravenous hydration and antibiotics.

“In 2022, people should not die of cholera,” Barboza said. “You don’t need a respirator or anything very complicated, but people are dying just because they don’t have access to healthcare. And this is not acceptable.”

Dismay as key oral cholera vaccine is discontinued | Cholera | The Guardian