The Value of and Challenges for Cholera Vaccines in Africa

The 21st century saw a shift in the cholera burden from Asia to Africa. The risk factors for cholera outbreaks in Africa are incompletely understood, and the traditional emphasis on providing safe drinking water and improving sanitation and hygiene has proven remarkably insufficient to contain outbr...

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Bibliographic Details
Published in:The Journal of infectious diseases 2013-11, Vol.208 (suppl 1), p.S8-S14
Main Authors: von Seidlein, Lorenz, Jiddawi, Mohammad, Grais, Rebecca F., Luquero, Francisco, Lucas, Marcelino, Deen, Jacqueline
Format: Article
Language:English
Subjects:
Africa - epidemiology
Cholera
Cholera - economics
Cholera - epidemiology
Cholera - prevention & control
Cholera vaccine
Cholera Vaccines - economics
Cholera Vaccines - immunology
Cholera Vaccines - supply & distribution
Cost-Benefit Analysis
Endemic Diseases - prevention & control
Epidemics
Epidemics - prevention & control
Humans
Mass immunization
Mass Vaccination - economics
Mass Vaccination - methods
Political campaigns
Potable water
Public health
Sanitary Engineering
Strategic Stockpile - economics
Vaccination
Vibrio
Vibrio cholerae
Water Supply
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Summary:The 21st century saw a shift in the cholera burden from Asia to Africa. The risk factors for cholera outbreaks in Africa are incompletely understood, and the traditional emphasis on providing safe drinking water and improving sanitation and hygiene has proven remarkably insufficient to contain outbreaks. Current killed whole-cell oral cholera vaccines (OCVs) are safe and guarantee a high level of protection for several years. OCVs have been licensed for >20 years, but their potential for preventing and control cholera outbreaks in Africa has not been realized. Although each item in the long list of technical reasons why cholera vaccination campaigns have been deferred is plausible, we believe that the biggest barrier is that populations affected by cholera outbreaks are underprivileged and lack a strong political voice. The evaluation and use of OCVs as a tool for cholera control will require a new, more compassionate, less risk-averse generation of decision makers.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jit194