Lessons learnt from 12 oral cholera vaccine campaigns in resource-poor settings

The World Health Organization (WHO) estimates that there are 1.3 to 4.0 million cholera cases annually and that 21 000 to 143 000 of them result in death.

1.  Additionally, in choleraendemic countries, 1.3 billion people are at risk of cholera.
2. The high morbidity and consequent mortality caused by cholera is attributable to several factors, including lack of access to safe drinking water, poor sanitation and poor hygiene practices (WASH).
3. Recent estimates suggest that cholera is endemic in 69 countries, with sub-Saharan Africa accounting for the majority of cases between 2008 and 2012 (7.0 of 11.6 million; 60%), followed by South East Asia (3.4 of 11.6 million; 29%).2 Improving water and sanitation is the preferred choice for cholera control in the long-term. Although progress has been made towards providing universal access to piped water and water treatment,4 663 million people worldwide still do not use improved drinking water sources that can reduce the spread of contaminants such as fecal matter.
4. Sanitation is likewise lacking for 2.4 billion people, 950 million of whom still practise open defecation.