The world’s oral cholera vaccine stockpile has run dry, while at least 16 countries face outbreaks. Africa experiences a disproportionately high cholera mortality rate; in three countries the number of cases quadrupled in one year, and 1,600 died. Manufacturers have already allocated upcoming vaccine doses elsewhere until mid-March, with growing demand surpassing supply. Médecins Sans Frontières (MSF) is calling for more manufacturers, and more technical support to help them. The shortage leaves communities unprotected, heightening the risk of preventable cholera deaths. This scarcity echoes past challenges, for example when a temporary one-dose vaccination measure was adopted in 2022. The current outbreaks are exacerbated by humanitarian crises and environmental factors like droughts, floods, and inadequate public infrastructure.