Worldwide, the oral cholera vaccine depended on a single manufacturer. When 2021 outbreaks in more than thirty countries simultaneously depleted reserves, the system collapsed: in October 2022, the WHO halted prevention campaigns entirely due to a lack of available doses. Three years and intensive contract negotiations later, the WHO announces an end to this bottleneck. On February 4, 2026, the organization revealed that annual oral cholera vaccine supply has doubled to 70 million doses, with the first campaigns resuming.
October 2022: The supply gap emerges
Cholera spread beginning in 2021 in an unusually broad global wave. Haiti, Syria, Yemen, Bangladesh, and more than thirty other countries reported outbreaks simultaneously, rapidly exhausting available vaccine stocks. In October 2022, the WHO ordered an emergency measure: the standard two-dose strategy was suspended because there simply were not enough doses available. Instead, single doses were used to reach more people with less vaccine. Prevention campaigns—vaccinations before outbreaks in high-risk areas—were halted entirely.
The problem was structural: the oral cholera vaccine was produced almost exclusively worldwide by South Korea-based manufacturer EuBiologics. When Shantha Biotechnics, a Sanofi subsidiary in India, announced in 2023 it would discontinue production of its Shanchol vaccine, the outlook deteriorated further.
2023 to 2025: Building capacity at high speed
Gavi, the international vaccine alliance, and UNICEF acted: they secured multi-year contracts with EuBiologics and financed production expansion. Gavi finances cholera vaccines through its global immunization program; UNICEF procures and delivers. In 2025, EuBiologics received a UNICEF order for 72 million doses for the current year, bringing production above the critical threshold for the first time.
The vaccine's protective effect is better than often perceived in public discourse. A 2024 study published in Healio showed that a single dose for adults provides at least 36 months of protection, while two doses protect for three to four years. For children aged one to five years, a single dose's protective duration is shorter, requiring special attention for this age group.
February 2026: Vaccination campaigns resume
The first allocation of 20 million prevention doses is distributed among three countries according to the WHO: Bangladesh receives 10.3 million doses, the Democratic Republic of Congo 6.1 million, and Mozambique 3.6 million. Mozambique launched the first campaign in February 2026 during an active cholera outbreak exacerbated by flooding. The target population includes children from age one and adults in high-risk areas.
On disease burden: in 2025, the WHO registered 601,845 cholera cases and 7,671 deaths across 33 countries. In 2024, the WHO registered over 560,000 cases and approximately 6,000 deaths. Compared to the 7,671 deaths in 2025, this fluctuation shows how heavily outcomes depend on local conditions.
In comparison: What vaccination campaigns deliver globally
Cholera is not an eradicable disease like smallpox or nearly polio. The pathogen Vibrio cholerae persists in the environment and spreads via contaminated water. Even complete vaccination coverage offers limited protection without improved drinking water access, as Médecins Sans Frontières (MSF) has emphasized in several position papers: vaccination campaigns alone are not a solution to the disease's structural causes.
Nevertheless, research demonstrates clear effectiveness. The polio vaccination program, operating with over two billion doses annually, has reduced global cases from 350,000 in 1988 to single digits. Cholera will never reach this scale because the disease is tied to infrastructure that vaccines cannot provide. But doubling to 70 million doses represents a first step away from pure emergency response toward systematic prevention.
Who comes next
The 20 million prevention doses are a fraction of global need. The Global Task Force on Cholera Control, comprising the WHO, UNICEF, MSF, and more than fifty other organizations, has set the goal of reducing cholera deaths by 90 percent by 2030 compared to 2016 baseline levels. To achieve this, countries like Ethiopia, Nigeria, and the Central African Republic would need to be served in future allocation rounds—all countries with persistently high outbreak numbers and limited water infrastructure.
With 70 million annual production capacity, the ambitious goal is mathematically within reach for the first time. Whether it is achieved depends not only on vaccine production but on investments in water supply, sanitation, and hygiene, which are far more expensive and politically complex than a supply contract with EuBiologics.