“NGOs, they cannot kill people”: Cholera vaccination in the context of humanitarian crises in South Sudan

Cholera is endemic and remains a significant public health problem in places like South Sudan where decades of war have devastated basic infrastructures and left people vulnerable to diseases mostly forgotten in other places. In 2010, the World Health Organization (WHO) recommended that oral cholera vaccination (OCV) be used in conjunction with other cholera prevention and control measures and an OCV stockpile was created to improve access to the vaccines in situations of outbreaks, humanitarian emergencies and other high risk settings. Four years later, following the eruption of a violent political crisisthat has left more than 50,000 people dead and another 2.5million displaced, OCV campaigns were conducted in PoCs (Protection of Civilian areas) across South Sudan with vaccines provided from the stockpile. This was the first use of the OCV stockpile in a humanitarian crisis. The potential social and health systems effects of the vaccine have so far been unexplored.