Kenya to benefit from global plan for more cholera vaccine doses

Kenya will benefit from a new plan by Gavi to supply millions of oral cholera vaccine doses to meet growing demand.

The new plan comes against a backdrop of a recent wave of cholera outbreaks around the world, including here in Kenya.

So far this year, 24 countries have reported cholera outbreaks, compared to 15 by mid-May last year.

The plan, developed in consultation with key partners including the World Health Organizaton, Unicef, the Global Taskforce for Cholera Control, and the Bill and Melinda Gates Foundation, will support large-scale preventive vaccination by 2026.

“The good news is we have doses to meet all emergency demand despite the rise in outbreaks, and that is expected to continue. But this trend underscores the increasing importance of preventing outbreaks before they occur,” said Dr Derrick Sim who is the managing director for vaccine markets and health security at Gavi.

He added, “The ultimate solution to both sustainable OCV supply and cholera control lies in our collective ability to step up our efforts on prevention programmes.”

Gavi is a global organisation that supplies vaccines to low-income nations. 

The beginning of Kenya's ongoing cholera outbreak was detected during a wedding festival in October 2022. Cholera can move fast. Within a month, 155 cholera cases were recorded in Nairobi county alone, the second-highest figure for any county across Kenya.

By the end of March 2023, the Ministry of Health had confirmed at least 7,800 cases and 122 deaths. Some 1,196 of those patients were from Nairobi county.

Gavi's roadmap outlines three areas where partners will work together to ensure supply is available to fully support both outbreak response and longer-term preventive vaccination.

It says in the short-term, the alliance partners will develop an allocation framework to provide consistency in demand, and transparency and equity in how doses will be distributed to countries in need for preventive vaccination is vital.

In parallel, Gavi said it is working to support new suppliers to enter the market more quickly and with higher volumes. The main current supplier, EuBiologics is also expected to increase its production capacity.

The roadmap also outlines the range of technical guidance and support needed to ensure countries can accurately map high-risk areas for cholera and plan ahead.

“This trend, coupled with countries’ increased interest in using OCV for cholera control among other disease control measures, has put a strain on the supply, with demand for emergency response spiking. From 2011-2020, approximately 38 million doses of OCV were used globally in response to cholera outbreaks,” Gavi said.

In 2021 and 2022, the wave of cholera outbreaks meant that nearly 48 million doses were needed for emergency response in those two years alone.

In response, the international coordinating body that manages how the Gavi-funded global stockpile of oral cholera vaccines is used for outbreak response recommended a temporary shift to a one dose strategy for outbreaks.

That was in line with WHO recommendations to ensure that available supply can continue to meet countries’ emergency OCV needs.

In the short-term, the roadmap forecasts that global supply will increase by the end of 2025, due to investments by EuBiologics, Gavi and BMGF in the development of vaccines that can be produced in higher volumes, and the expected entry of a new manufacturer.

However, if the current trend in outbreaks continues, supply for preventive vaccination will likely continue to be limited during this period, and will need to be allocated transparently and equitably, Gavi said.

By 2026, the roadmap forecasts that supply will start to meet demand for preventive vaccination, thanks to investments in increased capacity and additional manufacturers entering the market. This will enable large-scale preventive OCV campaigns in cholera-endemic countries.