Geneva, Maputo - Medecins Sans Frontieres (MSF) is carrying out field testing of a cholera vaccine, already proven in more limited trials, in the city of Beira, Mozambique. Mozambique is particularly badly affected by the disease, with epidemics becoming more frequent and a mortality rate there higher than average in Africa. The government is currently struggling to cope with the recurring epidemics because it can only react to an outbreak, rather than being able to prevent their occurence.
This is costly and disrupts the work of the public health services. An alternative, preventive strategy is urgently needed in Mozambique, as it is in most tropical African countries affected by cholera. The vaccine being tested by MSF, which is administered orally in two consecutive doses, is a very specific preventive tool, to be added to those which improve hygiene (sanitary education, access to clean drinking water, construction of latrines and drainage systems for waste water etc.).
The test project is being carried out according to priorities defined by the World Health Organisation (WHO), and in partnership with the local health authorities, MSF/Epicentre , the International Vaccine Institute of Seoul, and the local WHO office.
In practice, this is a massive vaccination campaign in the poor district of Esturro, in Beira, which has been particularly affected by cholera epidemics. MSF expects to administer the vaccine to approximately 50,000 adults and children, who have been informed by an awareness campaign conducted in the district. Those patients will receive the first dose of the vaccine between the 11th and the 24th of December, then the second between the 5th and the 15th of January.
The peak in the cholera epidemics is usually recorded between February and April. A first evaluation of the vaccination will take place immediately after the campaign in January. This will measure the feasibility of such a campaign in terms of organisation, and will assess its acceptability to the targeted population (participation, ingestion capability, side effects, etc.).
A second study is planned within the following six months, to assess the efficiency of the protection against the "vibrio", the bacterium responsible for the cholera disease. At present, two vaccines against cholera exist on the market, but only the one used by MSF in this Mozambique campaign has been granted a pre-qualification by the WHO. Even so, its cost is still relatively high for African countries, with a price ranging between three and six dollars per dose, depending on the quantity bought.