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1995 – 2020

The rapid global transfer of pathogens is an unpleasant consequence of the increasingly globalized world we live in today. With the high prevalence of infectious diseases today like the novel COVID-19, we pulled together the above infographic showing the top emerging disease outbreaks over the years.

Disease Outbreaks Over The Years In Brief


In 1995, over 45,000 Cholera cases worldwide were reported to the WHO. Cholera is an infectious disease that causes diarrhea, dehydration and even death. The disease has been devastating the world in recurrent pandemics since 1817.

Currently, there are three WHO pre-qualified oral cholera vaccines (OCV): Dukoral®, Shanchol™, and Euvichol®. In 2013, WHO established the OCV stockpile and received long term support from Gavi, the Vaccine Alliance for use of OCV in epidemic and endemic settings. As a result, along with guidance from the Global Task Force on Cholera Control (GTFCC), the targeted use of the vaccine in endemic, epidemic and humanitarian settings saw a significant rise. As of May 2018, over 25 million doses have been administered through mass vaccination campaigns in 19 countries.


An outbreak of the Ebola Virus Disease (EVD) was reported to the Ministry of Health in Uganda and persisted over a period of 3 months, spreading to two other parts of the country. Since then, there have been multiple outbreaks. The worst Ebola outbreak to date was the West African epidemic, which totaled nearly 30,000 cases and more than 11,000 deaths between 2014-2016. The world’s second worst Ebola outbreak on record was in the Democratic Republic of the Congo (DRC), in 2018. Till date, it has resulted in more than 3,000 cases and over 2,000 deaths with a staggering mortality rate of 65 percent.

Two vaccines have been approved, the first being Merck’s Ervebo. It is administered as a single-dose injection, and is a live, attenuated vaccine that has been genetically engineered to contain a protein from the Zaire ebolavirus. The FDA had granted this application Priority Review, Tropical Disease Priority Review Voucher and assigned Breakthrough Therapy designation. Due to the public health importance of developing a vaccine to prevent EVD, the FDA completed its evaluation of the safety and effectiveness of Ervebo in less than six months.

The 2nd vaccine approval was announced on 1st July by Johnson & Johnson in which the European Commission (EC) granted Marketing Authorisation for its Janssen Pharmaceutical Companies’ Ebola vaccine regimen. The vaccine composes of a two-dose regimen, Zabdeno® (Ad26.ZEBOV) and Mvabea® (MVA-BN-Filo). Currently, Janssen is collaborating with the World Health Organization (WHO) on vaccine pre-qualification, to accelerate registration of its regimen in African countries and facilitate broader access to those most in need. It is the first approved vaccine to be developed using Janssen’s AdVac® technology, which is also being used to develop vaccine candidates to protect against SARS-CoV-2, as well as Zika, RSV and HIV.


A global spread of (Avian Influenza) H5N1 began in Vietnam, leading to the forced killing of nearly 1.2 million poultry. A total of more than 468000 cases were reported.

Four vaccines have been developed at present. The first was a non-adjuvanted subvirion H5N1 avian influenza vaccine that was approved by the US Food and Drug Administration in 2007. Subsequently, an oil-in-water emulsion (AS03)-adjuvanted subvirion H5N1 avian influenza vaccine was approved for pre-pandemic use in the European Union in 2008 and in the United States in 2013. In 2020, an MF59-adjuvanted monovalent H5N1 avian influenza vaccine was approved in the United States for use.


CDC estimated that the H1N1 virus had killed over 500,000 people. It was detected first in the United States in 2009 and spread quickly across the United States and the world.

In the past, estimates of pandemic influenza mortality ranged from 0.03 percent of the world’s population during the 1968 H3N2 pandemic to 1 percent to 3 percent of the world’s population during the 1918 H1N1 pandemic. In the 2009/2010 pandemic, it was estimated that between 0.001 percent to 0.007 percent of the global population died of respiratory complications associated with (H1N1)pdm09 virus infection during the first 12 months the virus circulated.

Because of the pandemic, the WHO Pandemic Influenza A(H1N1) Vaccine Deployment Initiative was enacted and it coordinated the support of governments, foundations and manufacturers in facilitating access to pandemic H1N1 vaccines in countries eligible for assistance. As a result, millions of doses of vaccines and associated ancillary products (such as syringes and safety boxes) were donated, and considerable financial and logistical support pledged. WHO’s mandate ensured that the vaccines reached countries in need.


Currently, the COVID-19 pandemic has resulted in 24 million infected worldwide and counting, with no vaccine against the virus approved. 213 countries have been affected. At present, six COVID-19 vaccine candidates, including three from China, have entered phase-3 trials of August 2020. The three Chinese candidates are from Sinovac, Wuhan Institute of Biological Products/Sinopharm and Beijing Institute of Biological Products/Sinopharm while the other three are made by the University of Oxford/AstraZeneca, Moderna/NIAID and BioNTech/Fosun Pharma/Pfizer.

172 economies are presently in discussions to potentially participate in COVAX, a global initiative co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, and the World Health Organization (WHO). It aims to works with vaccine manufacturers to provide countries worldwide equitable access to safe and effective vaccines, once they are licensed and approved, for both higher-income and lower-income countries. COVAX currently has the world’s largest and most diverse COVID-19 vaccine portfolio – including nine candidate vaccines, with a further nine under evaluation and conversations underway with other mayor producers.

Sources: WHO // CDC