South Africa started a clinical trial for its oral cholera inoculation, the first developed from scratch locally in 50 years as President Cyril Ramaphosa has joined continent-wide calls for growing vaccine self-sufficiency.

Less than 1% of the world’s vaccines are made in Africa, even as infectious diseases are the leading cause of death on the continent, especially in children younger than five. Only a handful of African countries have vaccine-production facilities, with South Africa and Senegal the sole nations in the region with capacity to make them from start to finish.

If the trial is successful, the Biovac Institute — a partly State-owned developer — will sell the vaccine from 2028. Recent global outbreaks of the diarrhoeal disease have raised demand for inoculations.

Cholera, which tops the list of the five biggest outbreaks in Africa this year, has caused almost 7 000 deaths from about 300 000 suspected cases. The continent, which is also grappling with mpox, measles, dengue and Lassa fever, accounts for 94% of all cholera deaths.

Contracted by ingesting contaminated food or water and driven by conflict, poverty and climate change, cholera is resurging in several countries, according to the World Health Organization. This complicates containment efforts and strains fragile health systems.

“This development addresses a critical, life-saving need, given the ongoing global shortages of the vaccine amid recurring cholera outbreaks,” Biovac Chief Executive Officer Morena Makhoana said at a briefing Tuesday.

Biovac has ramped up its ability to make vaccines and last week launched a product-development laboratory in Cape Town to ensure a pipeline of vaccines and other therapeutics.