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* A global oral cholera vaccine (OCV) stockpile was established in 2013 to improve rapid access to the vaccine in outbreaks and emergencies in which cholera risk is high. The first deployment from the global OCV stockpile was to South Sudan in 2014 because of high cholera risk from massive population displacements within the civil war.

Two days after Haiti's devastating earthquake, a medical relief team made up in part of four emergency physicians and four emergency nurses from Stanford University Hospital and three emergency physicians from Columbia University Medical Center traveled under the auspices of the International Medical Corps, a nonprofit organization based in Los Angeles, to provide emergency medical support. Since there was no cold chain (temperature-controlled supply chain), we could not store either tetanus toxoid or tetanus immune globulin.

The first deployment from the global OCV stockpile was to South Sudan in 2014 because of high cholera risk from massive population displacements within the civil war. * 256,700 doses of OCV were delivered, with high coverage, throughout the country as part of a comprehensive cholera prevention strategy by multiple agencies, some of which had little to no previous experience with this vaccine. * A cholera epidemic began during vaccination, and a basic comparison of epidemic curves in vaccinated and unvaccinated areas suggests little to no transmission occurred in vaccinated areas, though more in depth analysis is needed. * This deployment highlights the feasibility of effective deployments from the OCV stockpile and the importance of strong coordination between governmental and nongovernmental agencies in cholera prevention and control planning from the assessment of cholera risk to the deployment of the vaccines. * A larger global supply of OCV is urgently needed to cover those most in need. Multisite Multipartner Oral Cholera Vaccination Campaigns This intervention targeted all nonpregnant IDPs who were at least one year old in PoC camps in Juba (Juba 3 and Tongping), Bentiu, Bor, and Malakal, in addition to Mingkaman camp (Fig 2).8 billion [9]) means that difficult choices will likely be confronted. [...]tools to identify populations in which the health benefits might be maximized in a timely manner (e.g., populations with the highest mortality risk or disease risk) are a clear priority that could facilitate the OCV decision-making process.

Increasing global conflicts and risk to humanitarian aid workers have necessitated innovative approaches to deliver humanitarian assistance. Remotely managed operations aim to continue the provision of services where grave risk to expatriate staff and restrictions by authorities inhibit access. This review of peer-reviewed and gray literature identified these remote approaches and collated lessons learned and best practices for humanitarian health programming and monitoring in inaccessible conflict settings. Analysis identified key principles, including the importance of capacity building and frequent communication, comprehensively assessing and addressing the risks to national staff, increasing monitoring and evaluation efforts despite difficult conditions, and planning for the possibility of a transition to remote programming and having an exit strategy to prevent falling into the remote operations trap. Evidence on how to effectively carry out remote operations is limited; rigorous documentation and evaluation of remotely managed humanitarian operations are required to further build the evidence base.