Preventive cholera vaccination is resuming for the first time in over three years, after global oral vaccine supplies reached sufficient levels, the Vaccine Alliance (Gavi), UNICEF, and the World Health Organization (WHO) announced Wednesday.

Mozambique is the first country to restart a preventive campaign, halted in 2022 due to a global surge in cholera cases, which led to vaccine shortages and forced health authorities to prioritize emergency responses.

This resumption comes amid a fragile situation in Mozambique, which is facing a cholera outbreak and the aftermath of recent floods affecting over 700,000 people and displacing many families. Floods disrupted health services and damaged water supply systems, increasing the risk of waterborne diseases.

“Global vaccine shortages trapped us in a cycle of outbreak response rather than prevention. We are now in a better position to break this cycle,” said WHO Director-General Tedros Adhanom Ghebreyesus, praising the efforts of South Korean manufacturer EUBiologics, currently the only large-scale cholera vaccine producer.

An initial allocation of 20 million doses is being deployed for preventive campaigns: 3.6 million doses to Mozambique, 6.1 million to the Democratic Republic of Congo, and 10.3 million planned for Bangladesh.

Thanks to sustained efforts by international agencies, partners, and manufacturers, the global annual supply of cholera vaccines rose from 35 million doses in 2022 to nearly 70 million in 2025. Vaccines are funded by Gavi and purchased and distributed by UNICEF.

UNICEF Executive Director Catherine Russell said the increase will “better prevent large-scale health emergencies” and prioritize protecting children, while emphasizing that vaccination must be paired with long-term investments in clean water, sanitation, and hygiene.

Beneficiary countries were selected according to criteria from the Global Task Force on Cholera Control (GTFCC) to ensure equitable and transparent distribution.

While the oral vaccine is safe and effective, agencies stress that vaccination is only one part of the response.

Cholera, spread through contaminated water and food, caused over 600,000 reported cases and nearly 7,600 deaths across 33 countries last year, likely an underestimate.

Long-term investments in infrastructure and surveillance remain essential to sustainably curb the disease.