Holistic approach to understanding the global impact of the oral cholera vaccine stockpile since inception

Cholera remains a significant public health concern globally. To address this, the World Health Organization and Gavi have coordinated an oral cholera vaccine (OCV) stockpile since 2013, enabling timely vaccine access for countries experiencing outbreaks. Using comprehensive shipment data and a transmission model, the current study assessed the impact of vaccination campaigns across all recipient nations over time. The analysis estimated health outcomes under both real-world conditions—with observed delays and supply shortages—and ideal scenarios where these constraints were eliminated. Under actual shipments, vaccination campaigns prevented approximately 8.1 million cholera cases and 146,013 deaths, averting 6.7 million disability-adjusted life years (DALYs) and reducing the economic burden by US$1.05 billion. In scenarios without delays or supply limitations, the benefits were even greater, with an estimated 17.4 million cases, 321,730 deaths, and 15.1 million DALYs averted. Enhanced timeliness and sufficient vaccine supply are key to maximizing public health impact.