Experts call for cholera vaccine ban to be lifted

Friday May 15th, 2009

Infectious disease experts called last night for wider use of a life-saving cholera vaccination.

Cholera is a major public health problem in the developing world. In 2007, 177,963 cholera cases and 4,031 deaths were reported to the World Health Organisation (WHO) from 53 countries - 94 per cent of cases in Africa. The true figures are likely to be much higher due to under-reporting.

Despite recommendations from WHO in 2001 for the use of new-generation oral cholera vaccines, no country has yet introduced cholera vaccines into its immunisation programme, with the exception of Vietnam. The oral vaccine used in Vietnam (ORC-Vac) does not comply with WHO guidelines, as it fails to meet quality standards.

Dr Sujit Bhattacharya of the National Institute of Cholera and Enteric Diseases in India, and colleagues, want the WHO to relax the rules. They describe ORC-Vac as "inexpensive, safe, and effective".

To be used outside of Vietnam, the vaccine must be produced in countries where the national regulatory authority has been approved by WHO.

Dr Bhattacharya and colleagues sit on a cholera Policy Forum run by the International Vaccine Institute in Seoul, South Korea. In a statement, published by Science, they say that lifting the ban "is necessary in order to effectively deal with the disease".

"The persistent lethality of the bacterial infection in Africa is proof that new strategies are needed," they state. "Meanwhile, very little has changed in the way aid groups have responded to these outbreaks."

The scope of the problem more than justifies the costs of vaccine implementation, they argue, adding that: "The lack of flexibility to adapt to the [current] circumstances is regrettable; for the people at risk it is a disaster."

Science May 15th 2009

Tags: Africa | Asia | World Health | Gastroenterology | Child Health | Travel