Critical Vaccine Shortage as Cholera Resurges Globally
In the final days of December 2022, the World Health Organization (WHO) sounded the alarm over a worsening global cholera vaccine shortage, as multiple countries grappled with surging outbreaks of the waterborne disease. The shortfall, reported in WHO’s monthly operational update on health emergencies, occurred at a time when cholera cases were rising at unprecedented levels in both endemic and previously unaffected regions, exacerbating the risks to vulnerable populations.
The most acute concerns centered around countries like Lebanon, where cholera reappeared in 2022 for the first time in nearly three decades. The Lebanese health system—already strained by economic crisis and infrastructure deficiencies—struggled to respond effectively amid severely limited access to oral cholera vaccines. By late December, the WHO confirmed that global vaccine stockpiles were insufficient to meet the growing need, prompting the organization to adopt emergency protocols and revise vaccination strategies.
A Growing Global Crisis
By the end of 2022, at least 29 countries had reported cholera outbreaks, marking one of the most widespread annual resurgences in over a decade. Nations across Africa, the Middle East, and parts of Asia faced especially severe challenges, with cholera spreading rapidly in communities lacking access to clean water, adequate sanitation, and health infrastructure. Countries like Haiti, Malawi, and Syria also saw steep increases in infections and mortality, putting further strain on local health systems.
Historically, the Oral Cholera Vaccine (OCV) has played a critical role in outbreak containment. However, the global supply—primarily produced by just two manufacturers—was quickly depleted by the escalating demand. In October 2022, WHO and its global health partners were already forced to switch from a two-dose to a single-dose regimen in emergency situations to stretch limited stocks. By late December, the situation had worsened, with many high-risk areas receiving little to no supply.
Emergency Measures and Strategic Allocation
In response, WHO initiated a set of emergency-use protocols to prioritize OCV deployment in the most severely affected regions. The International Coordinating Group (ICG), which oversees emergency vaccine stockpiles, worked with governments and health NGOs to triage supplies based on outbreak severity, population vulnerability, and healthcare accessibility.
While these stopgap measures were necessary, health experts warned that such emergency responses could not replace sustainable solutions. Dr. Philippe Barboza, WHO’s cholera lead, stressed that cholera is “a disease of inequity” and called for long-term investment in water, sanitation, and hygiene infrastructure (WASH) in addition to increased vaccine production.
Calls for Global Action
The vaccine shortage in December 2022 ignited global calls for increased production capacity and the diversification of manufacturing sources. Currently, most OCVs are produced by just two entities: Shantha Biotechnics (India) and Eubiologics (South Korea). Health agencies, including Médecins Sans Frontières and UNICEF, urged international donors and pharmaceutical firms to ramp up production and accelerate research into new formulations with longer shelf lives and easier delivery mechanisms.
The crisis also renewed focus on equitable access, as wealthier countries were seen as having more tools to prevent outbreaks through infrastructure and preventive care, while poorer nations faced recurring cycles of infection, under-resourcing, and humanitarian distress.
Conclusion
As 2022 came to a close, the cholera vaccine shortage stood as a stark reminder of the fragility of global health preparedness. With outbreaks expected to continue into 2023, experts warned that without swift action to bolster vaccine production, enhance sanitation infrastructure, and support at-risk communities, cholera could reclaim its place as one of the world’s deadliest infectious diseases.
Source:
World Health Organization – Monthly Operational Update on Health Emergencies (December 2022)
