WHO approves cholera vaccines producing firm to boost supplies

The WHO has given its approval to a third firm to produce oral cholera vaccines potentially doubling its global supply this year, in a bid to battle the diarrhoeal illness that is endemic in more than 50 countries.
The vaccine producer, a South Korean company called Eubiologics, is the third oral cholera vaccine (OCV) manufacturer to be approved under the WHO's pre-qualification and will produce 3 million doses of ORV which will push up the total global supply of ORV to 6 million doses.
The new vaccine is called Euvichol.
"It is certainly a step in the right direction", said Dr Stephen Martin, a WHO expert on emergency vaccine and stockpiles.

"It has a future potential in the next three or four years of a much greater increase in vaccine production," he said.
Cholera vaccine has been battling a global issue of shortage with only 50,000 doses of OCV available globally a few years back whereas the world sees between 1.4 million and 4.3 million cases every year, and as many as 142 000 deaths. Vaccination requires 2 doses per person.

WHO pre-qualification implies that the vaccines produced by Eubiologics have the stamp of approval from WHO for quality, safety and efficacy for countries battling cholera epidemics to either apply to WHO's OCV stockpile for procurement or buy it directly from the vaccine producers.

The other two WHO pre-approved manufacturers are a Hyderabad-based company called Shantha Biotechnics and a Swedish company called SBL Vaccines.
Shantha Biotechnics supplies to WHO's OCV stockpile while the Swedish company does not.
WHO has an OCV stockpile of 2 million doses to cover one million people.
In 2013, the WHO created the world's first OCV stockpile, undertaking to buy and use 2 million doses a year in order to stabilise and create demand for the vaccines.
Stockpiles are the WHO's mechanism for procurement and distribution of vaccines to match the population with the disease with the availability of vaccines.

Cholera, which is usually a disease of the poor, suffers from dearth of vaccination trapped in the vicious circle oflow demand, low production, high cost and inequitable access to the vaccine.
This mechanism was createdfollowing the outbreaks of meningitis in mid-90's in Africa where the International Coordinating Group was established to coordinate the best use of the limited amount of vaccine available.
"What a stockpile tries to do is to reverse that vicious cycle and turn it to a virtuous cycle-increase the demand, increase the production, decrease the unit cost andmake a more equitable access to the vaccine through distribution," Martin said.

Since the creation of the WHO's stockpile there have been 21 deployments, mostly in humanitarian emergencies, across 11 countries, including Nepal, Bangladesh and other African countries.
The new production may help in combatting cholera in endemic hotspots such as in Bangladesh and Democratic Republic of Congo.
Cholera, a diarrhoeal illness, is endemic in more than 50 countries across the world.
The WHO studied the cholera situation in India between 1997 and 2006and found that the highest number of reported outbreaks were in West Bengal, Odisha, Maharashtra and Kerala, which together accounted for 60 per cent of all reported outbreaks.
91 per cent of the cholera cases that occurred during the outbreaks were identified in Odisha, West Bengal, Andaman and Nicobar Islands, Assam and Chhattisgarh.

In the 10-year period, 823 deaths were reported, and the overall case fatality rate was 0.37 per cent.