The lack of vaccines for cholera it is possible to last until 2025 as outbreaks are reported around the world, the global vaccine alliance announced today, days after the World Health Organization warned that the short-term outlook for controlling the disease is bleak.

Cholera cases and deaths jumped last year as the deadly disease spread to new areas, particularly in conflict zones and areas with high levels of poverty.

In response, the World Health Organization and partners temporarily switched to using a single dose of vaccine, instead of the two that are normally given. But again they sold out last December.

The Gavi Alliance, an international body focused on childhood vaccination, said in a report that there are currently enough doses to meet emergency demand but not for preventive use.

Cholera is spread by consuming contaminated food or water and while it often causes mild or no symptoms, in severe cases acute diarrhea is produced, and the disease can be fatal within hours if untreated. Access to safe drinking water and sanitation is important to stop the spread of the disease, as is vaccination and rapid treatment.

According to world health organizations, it is difficult to strike a balance between preventive vaccination campaigns and dealing with emergency outbreaks as cases have increased.

The Gavi alliance reported that 48 million doses of vaccine were used in the past two years, 10 million more than in the entire previous decade. She said supply is expected to improve by 2026 as existing manufacturers step up efforts and a new company enters the market, and called for better planning to ensure vaccines are used where they are most needed, including for preventive campaigns.

In an update on Friday, the WHO said 24 countries have reported outbreaks so far this year, compared with 15 last year.

“The outlook is bleak. We are not able to provide enough vaccines,” said Henry Gray, the WHO’s official responsible for the global response to cholera, who said only 8 million of the 18 million doses requested had been made available in 2023.