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Cholera, a digestive infection caused by contaminated food or water, is on the rise.
According to the World Health Organization, every year, there are 1.3 to 4 million cases of cholera that led to 143,000 deaths, occurring mainly in South Asia and Sub-Saharan Africa. Right now, outbreaks are the worst they’ve seen in over 20 years.
“The number of countries with these large outbreaks occurring at the same time, we have not seen it in at least 20 years,” Dr. Philippe Barboza, the WHO lead for cholera emergencies, told the Telegraph.
Luckily, scientists have a new tool at their disposal: a cholera vaccine in capsule form.
While a number of cholera vaccines already exist, the current vaccination system is not working for outbreaks of this size, due to high costs and complicated delivery systems. The high demand for immunizations has also drained vaccine supplies, forcing experts to get creative.
What is DuoChol?
The new cholera vaccine capsules are called DuoChol and have been developed in partnership with the International Vaccine Institute (IVI), Gotovax AB, a biopharmaceutical company connected to the University of Gothenburg, and the Valneva Sweden AB pharmaceutical company.
The Wellcome Trust and Swedish government have also provided funding assistance.
“There has been a growing effort … for countries to identify populations at risk and do preventive campaigns,” Dr. Julia Lynch, director of IVI’s cholera program, told The Telegraph.
“But that’s been stymied by the shortage of vaccines. Over the last year-and-a-half, essentially all the vaccines in the stockpile went to outbreaks.”
That stockpile was created by the WHO in 2013 and deploys around 40 million doses per year — but more than 100 million are currently needed, according to Jan Holmgren, the man behind Dukoral, a drinkable cholera vaccine that makes up much of those 40 million doses.
According to the Telegraph, the drug is low-cost and has a similar composition to Dukoral. The capsule form, however, makes the treatment last longer by improving its thermostability (the duration of time during which active ingredients can remain stable at higher temperatures).
Putting the vaccine in capsule form also reduces its weight and volume, making it easier to deliver around the globe.
“This makes a big difference in mass vaccination campaigns when you are delivering hundreds of thousands of doses to one village or town,” Lynch told the Telegraph. “Those are really substantial, potential advantages on the logistics end.”
The new vaccine would only contain the two most relevant cholera strains. This will lower the cost of production while helping the drug deliver treatment as quickly as possible. A phase 1 clinical trial will launch next year.
Scientists are racing to meet the Global Task Force on Cholera Control’s target: to reduce cholera deaths by 90% by 2030.
This capsule is a dose of renewed hope.
Holmgren, the inventor of Dukoral, is a lead researcher on the DuoChol trials. He hopes phase 1 studies will be completed in 2024 and that the drug will go to market by 2027.
Holmgren writes for Wellcome: “With these new vaccine manufacturers, I think the global cholera vaccine supply will look much better and soon meet the demand for 100 million doses per year, if there is enough financial and political support.”
“Supporting IVI to take a new, low-cost oral cholera vaccine into a Phase I trial is an important step towards potentially expanding our global toolkit for this escalating disease and making these lifesaving products more accessible to those who need them most,” Dr. Charlie Weller, head of infectious disease prevention at Wellcome, said in a statement.
“This will be vital for helping to prevent and respond to future cholera outbreaks and save more lives.”
Header image courtesy of James Buck/Project HOPE