MALAWI — Gavi, the Vaccine Alliance  has announced the arrival of rapid diagnostic test (RDT) kits for cholera in Malawi, marking the start of a worldwide program that will distribute over 1.2 million tests to 14 cholera-prone countries over the next few months.

Ethiopia, Somalia, Syria, and Zambia are among the nations set to receive kits, all of which are now experiencing severe cholera outbreaks.

The program intends to improve outbreak detection and response by increasing routine surveillance and testing capability, allowing for the rapid identification of suspected cholera patients.

Furthermore, this project will allow countries to track trends and build an evidence base for future preventive measures, so helping to the achievement of national cholera control and elimination targets.

The worldwide cholera diagnostics initiative, coordinated and supported by Gavi, the Vaccine Alliance, in conjunction with UNICEF, the worldwide Task Force on Cholera Control (GTFCC), and WHO, has received input from a variety of organizations, including FIND.

These initial shipments signal the program’s launch, with intentions to expand RDT deployment to other interested countries in the future.

The program’s long-term viability is dependent on effective fundraising during Gavi’s strategic period from 2026 to 2030.

This collaborative effort will shift quick diagnostic tests from being utilized only for epidemic response to routine cholera surveillance.

Pilot studies conducted in the Democratic Republic of the Congo (DRC), Niger, and Nepal, funded by Gavi and led by institutions such as the United States Centers for Disease Control and Prevention (CDC) and Johns Hopkins University (JHU), provided valuable insights that informed the program’s design.

Cholera outbreaks have increased globally since 2021, with high case fatality rates despite the availability of simple, effective, and economical treatments.

The enormous demand for vaccinations has stretched the global supply, causing delays in preventive immunization campaigns.

Recurring outbreaks in nations where emergency vaccination campaigns have been implemented highlight the importance of enhancing outbreak detection and response skills.

So far, the Gavi Board invested US$55 million in 2021 to finance a diagnostics program including cholera, yellow fever, measles, rubella, meningococcal meningitis, and typhoid from 2022 to 2025.

The initiative aims to improve disease surveillance, outbreak identification, response, and prevention program design.

Gavi’s cholera diagnostics application window, which opened in June 2023 and remains open, has received applications from 14 countries, all of which have been accepted by an independent review committee of experts.

Gavi also initiated a preventive cholera vaccine initiative in 2023, building on its successful approach to reducing outbreaks of diseases such as yellow fever and meningitis.

Cholera, an acute intestinal infection spread by contaminated food and water, is still prevalent due to persisting gaps in access to safe water and sanitation, which are worsened by climate-related factors, conflict, and population relocation.

Addressing these problems would necessitate coordinated efforts to improve epidemic response, case management, vaccine production, and the availability of basic water and sanitation services.

These needs increased efforts in outbreak response, case management, vaccine development, and access to basic water and sanitation facilities in impacted areas.

These multisectoral solutions’ effectiveness depends on timely and trustworthy cholera surveillance data, as underlined by the Global Task Force on Cholera Control’s updated recommendations for 2023.

The worldwide cholera RDT procurement initiative intends to assist qualifying nations in following these suggestions, thereby improving cholera monitoring.

Commenting on the arrival of the RDT kits, Aurélia Nguyen, Chief Programme Officer at Gavi, stressed the importance of routine diagnostics in improving cholera surveillance and successfully focusing vaccination efforts.

In her speech, Leila Pakkala, Director of UNICEF’s Supply Division, emphasized the accuracy provided by surveillance diagnostics in detecting cholera hotspots and improving vaccine deployment to save lives.

Dr. Michael Ryan, Executive Director of WHO’s Health Emergencies Programme, on his part,  praised the implementation of quick cholera testing, underscoring its importance in preventing epidemics early and improving prevention and treatment efforts.

Dr. Sergio Carmona, acting CEO and Chief Medical Officer at FIND, finished by emphasizing the significance of precise testing and surveillance techniques in guiding resource allocation and evaluating preventive actions.

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