Cholera: the global program to distribute 1.2 million rapid diagnostic tests in 14 at-risk countries

ROMA – The arrival of rapid cholera diagnostic test kits in Malawi marks the start of a global program that will see the distribution of more than 1.2 million tests to 14 high-risk cholera countries in the coming months. Among the countries that will receive the kits in the coming weeks, as part of this largest-ever global distribution, are those currently severely affected by cholera epidemics, such as Ethiopia, Somalia, Syria and Zambia.

Cases have been increasing globally for three years. As of 2021, cholera has been on the rise globally, with high mortality rates despite the availability of simple, effective and affordable treatments. The large number of outbreaks has led to unprecedented demand for vaccines from affected countries. Although the global supply of oral cholera vaccines increased eighteen-fold between 2013 and 2023, the sharp and prolonged increase in demand over current availability has put a strain on global supplies. Preventive vaccination campaigns have been delayed to preserve doses for emergency outbreak response efforts. Recurring outbreaks in countries where emergency vaccination campaigns have already been implemented further highlight the need to improve the speed and accuracy of identifying areas with new or persistent transmission, so that they can be targeted during initial efforts response to outbreaks.

Difficult access to drinking water. The increase in cholera is due to continued gaps in access to drinking water and sanitation and the inability to quickly identify outbreaks and limit their spread. Affected communities often lack access to basic health services, a situation exacerbated by factors related to climate, conflict and population displacement. In the face of the ongoing surge, cholera control partners have urgently called on countries, producers and other partners to invest in timely outbreak response and case management, rapid access to treatment, in scaling up the production of affordable vaccines and urgently improving access to basic water and sanitation services in affected communities.

The global diagnosis program. The global cholera diagnostic program is funded and coordinated by Gavil’Vaccine Alliancewith procurement and delivery to countries led by UNICEF and undertaken in collaboration with the Global Task Force on Cholera Control (GTFCC) and theWorld Health Organization. The program will improve the timeliness and accuracy of outbreak detection and response, enhance routine surveillance and testing capacity, and help rapidly identify probable cholera cases. Furthermore, it will help countries monitor trends and build an evidence base for future prevention programs, supporting the achievement of national cholera control and elimination goals.

Routine diagnostics will help. “We are seeing an unprecedented multi-year surge in cholera cases around the world – said Aurélia Nguyen, Chief Program Officer of Gavi, the Vaccine Alliance – and today’s announcement provides a vital boost to the fight against the disease. The increase in infections is due to continued gaps in access to drinking water and sanitation and the inability to reach vulnerable communities, further put at risk by climate change, conflict and displacement. The routine use of diagnostics will strengthen cholera surveillance in affected countries and must be leveraged to better target vaccination efforts, which play a key role in multisectoral cholera prevention and control programs.”

The urgency of bringing vaccines to where they are needed. “Although cholera is preventable and easily treatable – said Leila Pakkala, director of the Supply Division dell’UNICEF – children continue to suffer from this potentially fatal disease. That’s why we are working with our partners on all fronts and in new ways to stem outbreaks. Surveillance diagnostic systems help detect outbreaks with great precision. And this allows partners to target cholera vaccines at exactly the time and place where limited supplies will save the most lives.”