Programmatic Preparations and challenges for OCV introduction in India.

Area of Science:

• Public Health
• Epidemiology
• Vaccinology

Background:

• Cholera disproportionately impacts marginalized populations lacking access to essential services like clean water and sanitation.
• India faces a significant cholera burden, with millions at risk and hundreds of thousands of cases and thousands of deaths reported annually.
• A global cholera elimination plan by 2030 necessitates a comprehensive, multi-stakeholder approach.

Purpose of the Study:

• To review the evidence on cholera burden in India.
• To evaluate successful oral cholera vaccine (OCV) implementation strategies globally.
• To inform the decision-making process for incorporating OCV into India's Universal Immunization Programme (UIP).

Main Methods:

• Review of epidemiological data on cholera incidence and mortality in India.
• Analysis of case studies on OCV implementation in various countries.
• Consultation and recommendation by the National Technical Advisory Group on Immunization (NTAGI) Working Group on Cholera.

Main Results:

• An estimated 411 million people in India are at risk of cholera.
• Approximately 675,188 cases and 20,256 deaths occur annually in India due to cholera.
• Successful OCV implementation in other nations provides a viable model for India.

Conclusions:

• The NTAGI recommends integrating OCV into India's UIP to control cholera.
• Key steps for OCV introduction include vaccine selection, delivery strategy, resource allocation, manufacturer engagement, and post-introduction evaluation.
• A strategic multi-stakeholder approach is crucial for effective cholera control and elimination in India.