A future free from cholera: Bangladesh takes bold action

Across the Beri Badh Bridge in south-west Dhaka lies Kamrangirchar, a densely populated neighbourhood of around 600 000 people, both long-term residents and internal migrants. Butcher shops, medicine stores and sugar-cane juice stalls crowd the narrow streets. Power lines tangle overhead.

For many who live here, access to safe water remains a particular challenge, with the national picture already difficult: 98.6% of people in Bangladesh have access to basic drinking-water services, but only around 39% have access to safely managed drinking water.

This leaves communities like Kamrangirchar particularly vulnerable to cholera. To help protect those most at risk, it is one of seven thanas in urban areas and seven upazilas nationally included in a preventive oral cholera vaccination (OCV) campaign led by the Ministry of Health and Family Welfare, and supported by the World Health Organization (WHO), Gavi, the Vaccine Alliance, UNICEF, the International Federation of Red Cross and Red Crescent Societies, and icddr,b.

The first round of the campaign was implemented from 22 August to 21 September, targeting more than 5.17 million people aged one year and above. A second dose is being offered from 26 September through 25 October. Together, both rounds are part of a broader plan to end cholera as a public health threat by 2030, alongside stronger surveillance, improved access to safe water and sanitation, and sustained action in communities at greatest risk.

“The best time to stop cholera is before people get sick,” says Dr Rezaul Hossain, WHO Surveillance and Immunization Medical Officer (SIMO) in Dhaka South City Corporation, where Kamrangirchar is located. “We know where the risks are greatest, and what makes people vulnerable. And we also know that when communities, health services and partners tackle those risks together, we can do more than stop the next outbreak – we can move closer to a future free of cholera.”

A community mobilized

On a market holiday morning during the first round of the campaign, Kamrangirchar 31-bed Hospital is buzzing. Residents clutch vaccination cards; parents balance children on their hips. 

^{Habib with his eight-month-old daughter, Humira, at Kamrangirchar 31-bed Hospital. (WHO/Abdul Mannan Dipto)}

Among those waiting is Habib, a 30-year-old jute-bag seller, with his eight-month-old daughter, Humira. Too young for OCV, Humira receives measles-rubella vaccination while her father gets his first OCV dose.

“I heard about the vaccine from my neighbours, whose children learned about it from their teachers," he says, holding Humira. “I’ll be back for the second dose.”

A few feet away, 27-year-old Chameli and her youngest child have just received their vaccines. “I came here to take the vaccine for both me and my child,” she says, explaining how she was recently treated at the hospital for diarrhoea and stomach pain. “My eldest has already taken the vaccine, and we will all take the second dose as well.”

The 31-bed Hospital is the hub for around 65 vaccination centres across Kamrangirchar, including both mobile and fixed sites in schools and other community locations.

Faith leaders have played an essential role in mobilizing the community. Imam Md Faiz Ahmed, who leads prayers at the hospital mosque, has encouraged worshippers, madrassa students and other residents to get vaccinated, and has visited other mosques to spread the message. 

^{Imam Md Faiz Ahmed has helped carry vaccination messages through mosques and into the wider community in Kamrangirchar. (WHO/Abdul Mannan Dipto)}

“I tell people that they should take the vaccine to prevent cholera, and that it will only be available during the campaign,” he says, kneeling in the hospital’s fourth-floor prayer room. “I ask them to also take their children so they can be protected.”

Towards 2030

By 21 September, at the end of the first round, the campaign had reached 82.2% of the target population nationally, including 80.8% in Kamrangirchar.

“Reaching eight out of every ten people in Kamrangirchar means more people are protected and fewer families are at risk from cholera,” says WHO SIMO Dr Rezaul Hossain. “In a community where people live close together and access to safe water can be difficult, that protection matters. But there are still people we need to reach, and our work is not finished.”

With the second round now underway, the immediate task is to build on that progress and increase protection, while sustaining action on the wider conditions that continue to put communities at risk.

“Reaching so many people in such a short period shows what is possible when government, communities and partners work together,” says Dr Ahmed Jamsheed Mohamed, WHO Representative to Bangladesh. “The challenge now is to carry that same determination through the next round of the campaign and beyond: strengthening surveillance, expanding access to safe water and sanitation, and reaching communities at greatest risk.”

In Kamrangirchar, as in selected thanas and upazilas across the country, vaccination teams are again working in communities. Habib and Chameli will return for their next dose. Millions of others will do the same. Bangladesh will continue its journey towards a future free from cholera.