Development of DuoChol, a novel heat-stable oral cholera vaccine

In the 1990s, Jan Holmgren’s group developed Dukoral — the world’s first effective and WHO-approved oral cholera vaccine (OCV) — and through technology transfer, contributed to subsequent, locally produced, and lower-cost OCVs such as OrcVax, Shanchol, and the recently registered single-component OCV Hillchol. DuoChol is a novel, third-generation, heat-stable OCV consisting of a freeze-dried mixture of formalin-killed isogenic V. cholerae O1 Ogawa and Inaba bacteria and the cholera toxin B-subunit (rCTB) in an enteric-coated capsule; it is being developed in collaboration with IVI with the support of Wellcome Trust and is currently undergoing GMP manufacturing for a Phase 1 trial scheduled for spring 2027. Its heat stability, practical formulation, low cost, and enhanced efficacy make DuoChol ideal for national cholera control programs.