December 7, 2011 (Decatur) - Endemic and epidemic cholera are present in many parts of the world and account for approximately 100,000 deaths annually. Widely agreed responses to the occurrence of cholera are: a) Detection, diagnosis, and treatment of cases with oral rehydration and antibiotics, b) Assuring a safe water supply, and c) Assuring implementation of adequate waste disposal and sanitation measures.
Inexpensive and safe oral cholera vaccines (OCV) have been found to be effective in large efficacy and effectiveness trials in South Asia and Africa, but are not yet used widely. Based on the experience with OCV in these regions, the World Health Organization recommends that OCV should be used in endemic areas, pre-emptively in populations at high risk and considered for reactive use to control outbreaks. Although there is a clear recommendation for using OCV, there is not yet a consensus on strategy nor guidance for implementation or delivery in epidemic settings. Also, there is need for greater clarity on its use during outbreaks in large scale humanitarian crises. A meeting held at the World Health Organization in May 2011 concluded that OCV should be included as a part of an integrated and comprehensive cholera control and prevention strategy during such outbreaks, but again the exact strategy for implementing such a recommendation needs clarification.
The Bill & Melinda Gates Foundation recently provided funding to The Task Force for Global Health, through a two-year grant to establish the Coalition for Cholera Prevention and Control (CCPC), a coalition of partners focused on developing a comprehensive strategy for the prevention and control of cholera, to include appropriate use of oral cholera vaccines, in both endemic and epidemic settings.
The Task Force for Global Health will serve as the primary grantee and partner with Harvard Medical School/Partners In Health in convening a coalition of 30-35 experts to develop a comprehensive global strategy for cholera prevention and control. Cornell University/GHESKIO will actively participate in the coalition along with Johns Hopkins University, Dartmouth College, International Vaccine Institute, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB), the World Health Organization/Pan-American Health Organization, the Centers for Disease Control and Prevention (CDC), United Nations Office for the Coordination of Humanitarian Affairs, UNICEF, ministries of health in cholera-affected countries, and many others. The coalition will meet in early 2012.
The project will be co-led by Alan R. Hinman, MD, MPH, and Paul Farmer, MD, PhD. Dr Hinman is Acting Director of the Center for Vaccine Equity at the Task Force for Global Health and a former CDC Assistant Surgeon General. At the CDC, he served as Director of the Immunization Division, Director of the National Center for Prevention Services and Senior Advisor to the Director. Dr. Hinman chairs the WHO Advisory Committee on Quantitative Immunization and Vaccines Related Research (QUIVER) and serves on the Executive Board of the GAVI Alliance, representing Civil Society. Dr. Farmer is the Kolokotrones University Professor at Harvard University and the Chair of the Department of Global Health and Social Medicine; he co-founded Partners In Health and also serves as Chief of the Division of Global Health Equity at the Brigham and Women’s Hospital and as the Deputy UN Special Envoy for Haiti.
The Task Force for Global Health
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