Pathways to a policy for cholera control in India.

Cholera is endemic in southern Asia, but available control mechanisms have either not been applied or have been ineffective. Oral killed cholera vaccines are now available, are pre-qualified by the World Health Organization (WHO) and are being stock-piled by the Gavi Alliance. Although cholera vaccines have been tested, manufactured and licensed in India for several years, they are not in use in public health programmes for either endemic disease or outbreaks. The National Technical Advisory Group on Immunization (NTAGI) is the advisory body that considers disease burden, vaccine performance, cost-effectiveness and potential for introduction into national programmes, reporting to the Ministry of Health. The NTAGI also takes into account the recommendations of the WHO and is now considering cholera vaccines. Policies for cholera control are urgently needed, and the availability and affordability of an oral cholera vaccine in India offers new opportunities to control an important public health problem.