Development of DuoChol, a low-cost, thermostable oral cholera vaccine

We developed in the 1990s the world´s first effective and WHO-approved oral cholera vaccine (OCV) Dukoral, and through technology transfer also contributed to later, locally produced lower-cost OCVs, such as OrcVax, Shanchol and the recently registered single component Hillchol OCV. DuoChol is a 3rd generation novel, thermostable OCV consisting of a lyophilized mixture of formalin-killed isogenic V. cholerae O1 Ogawa and Inaba whole-cells and cholera toxin B-subunit (rCTB) formulated in an enterocoated capsule and co-developed with IVI, now in GMP for Phase 1 early 2025. Heat stability, practical formulation, low cost and increased efficacy compared with current OCVs makes DuoChol attractive for national cholera control programs and the ideal OCV in cholera outbreaks where rapid deployment and maximal early efficacy are essential.