A single factory bottleneck forced the world to ration cholera protection for years, and that fragile reality just changed.

Quick Take

• Global oral cholera vaccine supply rose from 35 million doses in 2022 to nearly 70 million in 2025, reopening the door to prevention.
• Preventive campaigns had been paused for more than three years as outbreaks surged and stockpiles shifted to emergency-only use.
• Mozambique launches the first renewed preventive push in February 2026 with 3.6 million doses, while floods strain water systems for hundreds of thousands.
• Additional allocations target other high-burden settings: 6.1 million doses for the Democratic Republic of the Congo and 10.3 million for Bangladesh.
• Officials praise the milestone but warn the vaccine only buys time unless communities get durable water and sanitation upgrades.

From triage to prevention: what “enough doses” really means

Global health agencies stopped pretending they could “vaccinate ahead of the wave” when cholera vaccine supply collapsed into scarcity in 2022. With only about 35 million oral cholera vaccine doses available worldwide, planners shifted to triage: respond to active outbreaks, skip preventive campaigns, and accept that the next emergency would arrive before the last one ended. The new milestone—nearly 70 million doses by 2025—restarts prevention, but it also raises a harder question: can the system keep up when fear fades?

Cholera spreads through contaminated water, so the public often assumes the “real fix” is pipes, pumps, and hygiene, not a vaccine. That’s true in principle and incomplete in practice. Oral cholera vaccine offers a practical bridge when storms, conflict, and weak infrastructure turn everyday drinking water into a transmission route. One dose can protect for about six months; two doses can extend protection to around three years for people over age one. That timing explains why preventive campaigns matter: they interrupt transmission before hospitals overflow.

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Mozambique’s February campaign: a test under flood conditions

Mozambique becomes the opening act for the resumed preventive era, starting a campaign in February 2026 after receiving 3.6 million doses. The backdrop isn’t theoretical. Floods have disrupted water systems and affected more than 700,000 people, conditions that make cholera spread fast and punish the youngest first. A prevention campaign in that setting functions like a firebreak. It won’t rebuild a water network, but it can reduce the odds that a localized problem becomes a national crisis.

The allocations to the Democratic Republic of the Congo and Bangladesh show the strategy’s real shape: aim for limited supply where risk stays high, not where headlines feel loudest. The global partners set criteria through the Global Task Force on Cholera Control, a network of more than 50 organizations that tries to keep distribution rules transparent. That matters because vaccines become political the minute they become scarce. Equitable allocation doesn’t eliminate conflict, but it reduces the temptation for influence campaigns and backroom deals.

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The uncomfortable dependency: one producer carries the load

Every supply milestone comes with a vulnerability hidden inside it. Mass-scale production still depends on a single manufacturer, EUBiologics, to carry most of the world’s oral cholera vaccine output. That is not a moral failing; it’s a supply-chain fact. When one producer dominates, any disruption—quality issues, raw material delays, shipping snarls—can shove the world back into emergency-only mode. Calls from global leaders for additional producers are common sense. Competition isn’t just economic; it’s resilience.

Gavi finances the global stockpile, UNICEF procures and delivers doses, and WHO helps coordinate the response. That partnership can look like bureaucratic sprawl until you watch what it accomplishes: bulk buying, standardized planning, and a buffer against political favoritism.

GOOD NEWS: Preventive cholera vaccination resumes as global supply reaches critical milestone, first time in 3 years https://t.co/vYatguHUf3

First country to restart the preventive vaccination: Mozambique 🇲🇿, to be followed by Bangladesh 🇧🇩 and DRC 🇨🇩

What does this mean: We… pic.twitter.com/FyM1XfrgxY

— World Health Organization (WHO) (@WHO) February 4, 2026

The one-dose strategy: practical compromise, not perfection

The decision to lean on a one-dose approach reflects the ugly math of outbreaks. Two doses provide longer protection, but two doses also double immediate demand, slow rollout, and strain fragile cold-chain logistics. When cases rise across dozens of countries, a one-dose strategy spreads short-term protection wider, faster. That’s not a marketing slogan; it’s a risk-management choice. The tradeoff is obvious: communities need follow-up planning, or the protection window closes just as the next rainy season opens.

The global context explains why “prevention resumes” carries weight. In 2025, more than 630,000 cholera cases were reported across 33 countries despite a slight decline, a signal that the disease remains entrenched where water systems fail and governance struggles. Vaccines can reduce illness and death quickly, but cholera thrives on predictability: flooded neighborhoods, crowded shelters, broken sewage, and delayed repairs.

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What should make taxpayers care: security, stability, and realism

Americans don’t need a guilt trip to understand why controlling cholera abroad matters. Infectious disease pressure destabilizes regions, overwhelms local economies, and intensifies migration incentives. Prevention costs less than prolonged emergency response, and it protects children who bear the brunt of waterborne disease. The strongest claims in this story are modest and credible: supply expanded, campaigns can restart, and the vaccine buys time. The weakest claim would be any promise that vaccines alone “solve cholera.” They don’t. Water and sanitation do.

The real cliffhanger sits in the next production cycle. A doubled supply sounds like victory until demand doubles again—through climate shocks, conflict, or simple underinvestment in basic infrastructure. Global leaders publicly urge more manufacturers to enter the market for a reason: the world cannot run preventive cholera control on a single-thread supply chain. Mozambique’s campaign will deliver a signal. If prevention reduces outbreaks and governments pair it with water and sanitation upgrades, the world moves from panic to planning.

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Sources:

Global cholera vaccine supply reaches critical milestone, preventive campaigns resume
Cholera Vaccination Restarts Worldwide as Supply Achieves Key Milestone
Preventive cholera vaccination resumes as global supply reaches critical milestone
Boosted global supply of vaccine, preventive cholera vaccination resumes
Cholera Vaccinations Resume, Supply Reaches Milestone