Policy Shifts on Use of Oral Cholera Vaccine

For Djencia Eresa Augustin, helping to administer the oral cholera vaccine this spring was one thing she could do to fight the cholera epidemic raging through her country. Thanks to her efforts—and the partnership of hundreds of other community health workers, Haiti’s ministry of health, and the nonprofit organization GHESKIO—nearly 100,000 people received the vaccination earlier this year.

“From everything I’ve seen, there is no one who was eligible for the vaccine who didn’t want it,” Augustin said.

Djencia Eresa Augustin is one of hundreds of community health workers who made the oral cholera vaccine campaign in Haiti a success.

For her and others on the front line of cholera epidemics—in Haiti and around the world—the announcement last week from a working group of the World Health Organization (WHO) comes as a welcome affirmation of their efforts. The Pan American Health Organization’s Technical Advisory Group on Vaccine-Preventable Diseases (PAHO TAG) recommended expanding the use of the oral cholera vaccine in Haiti, based in part on data that Dr. Louise Ivers, PIH’s senior health and policy advisor, presented on behalf of PIH and its sister organization Zanmi Lasante. Dr. Bill Pape presented data from GHESKIO’s portion of the campaign.

“An important part of our campaign was to ensure that our experience informed the control of cholera in Haiti and in other countries,” Ivers said. “While cholera vaccines aren’t ‘golden tickets,’ we must move quickly to save as many lives as we can with the tools we have now.”

During last week’s meeting in Washington, DC, Ivers presented data from the successful vaccine campaign, which began in April and finished in June. For example, in a rural area near St. Marc, 45,368 people were vaccinated, and 90.8 percent were confirmed to have received the second dose—a very high completion rate.

In another piece of good news, the World Health Organization also endorsed a recommendation that a global stockpile of 2 million oral cholera doses be created to respond to outbreaks around the world—a major policy shift on the emergency use of cholera vaccines.

In Haiti, the work that PIH, the government, and other partners are doing to improve the country’s water and sanitation infrastructure continues—and is critical. But vaccines are a necessary component of a comprehensive strategy to fight an epidemic that has killed more than 7,000 Haitians, sickened half a million, and continues to claim lives.

“The PAHO TAG recommendations to scale up use of the vaccine in Haiti and the WHO endorsement of a stockpile of cholera vaccines are both great strides forward for those at risk of cholera in Haiti and worldwide,” said Ivers.