GENEVA, Switzerland (AFP) – Oral cholera vaccine production last month reached its highest level in more than a decade, the WHO said Wednesday, but warned there was still not enough to meet the surging demand.

The World Health Organization had warned in October that the global stockpile was effectively depleted, hampering attempts to bring the disease under control.

The UN health agency said production of oral vaccine doses surged last month thanks to new formulations and manufacturing methods.

“This increase allowed the average stock to rise to 3.5 million doses in November compared to 600,000 in October — closer to the five million doses needed for emergency stockpile at all times for effective outbreak response,” the WHO said in its monthly situation report.

“However, increased production has not met the rising global demand,” it said, warning that “this persistent shortage continues to hinder efforts to control cholera outbreaks and respond promptly to the disease’s spread”.

This year, 10 countries carried out reactive vaccination campaigns, targeting 31 million people.

Amid insufficient supplies, only one of the usual two doses were administered during those campaigns.

The WHO highlighted “the urgent need to scale up production and improve strategic stockpile management to meet both reactive and preventive vaccination needs effectively”.

Cholera is an acute intestinal infection that spreads through food and water contaminated with the bacterium vibrio cholerae, often from faeces.

It causes severe diarrhoea, vomiting and muscle cramps.

Cholera can kill within hours when not treated, though it can be treated with simple oral rehydration, and antibiotics for more severe cases.

– ‘Increasingly complex’ –
In 2023, 535,321 cases and 4,007 deaths were reported to the WHO from 45 countries.

This year, up to 24 November, 733,956 cholera cases and 5,162 deaths were reported from 33 countries.

“Conflict, mass displacement, natural disasters, and climate change have intensified outbreaks, particularly in rural and flood-affected areas, where poor infrastructure and limited healthcare access delay treatment,” the WHO said.

“These cross-border dynamics have made cholera outbreaks increasingly complex and harder to control.”

The WHO said the increased number of cases and deaths reported this year was largely due to updated data from war-torn Yemen, where 245,776 cases and 861 associated deaths were recorded.

After Yemen, the countries with the most recorded cases this year were Afghanistan (165,629), Pakistan (72,832), Sudan (38,903), the Democratic Republic of Congo (28,804) and Ethiopia (26,718).

Since last month’s report, new cholera outbreaks have been reported in Cameroon, Mozambique, Uganda and Zimbabwe.