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Challenges for Programmatic Implementation of Oral Cholera Vaccine in India. Cholera remains a major contributor of diarrheal diseases and leads to substantial morbidity and mortality particularly in low socio- economic setting. Non-availability of National Cholera Control Plan in India, compounded by underreporting of cholera cases and deficient accurate cholera hotspot estimates has made cholera control a challenge.Obstacles in programmatic introduction of Oral Cholera Vaccine (OCV) lie within its infrastructure- stockpile, costing, distribution system, cold chain mechanism, vaccine logistics and lack of strengthened Adverse Event Following Immunization (AEFI) surveillance systems. Sustained political commitment along with sensitization of media people will also determine policy outcome of OCV introduction in India.