Cholera, in a number of low and middle income countries is both an endemic and an epidemic disease (LMICs). Cholera control strategies include improvement of water, sanitation and hygiene; early and efficient treatment; and the implementation of an oral cholera vaccine (OCV). The costing of the integration into OCVs in LMICs using an Excel-based method called the CholTool is described in this document. It includes estimates of the delivery of costs which include not only the cost of delivery, but also the programmatic costs of introducing a new vaccine.

CholTool users are taken to generate personalised cost estimates based on standardised methods by means of a hierarchical series of connected modules containing entry parameter cells, judgement cells, and formulas. This tool offers calculations of both financial and economic costs to ensure that the two costs are usable.

Economic distribution costs per dosage were estimated to be $2.89 in Ethiopia, $3.04 in Malawi 1, $3.35 in Malawi2, and $3.06 in Nepal. In Nepal, a cost projection performed prior to the initiative using the tool and a retrospective costing conducted using the tool yielded no substantial gap in economic distribution costs per dosage.