How should policymakers make decisions that are informed by honest assessment of both local capacity and new technologies, including vaccines? Decision analysis might prove useful in public health decision making and help to determine what resources should be invested to enhance the availability of clean water, diagnose and treat cholera, and distribute vaccines. Yet, these should not be envisioned as competing strategies (6). Because cholera is part of a vicious cycle of poverty, poor sanitation, water contamination, and a weak health system, we argue for an approach that combines prevention and care at every step. On the basis of our experience combining treatment of tuberculosis and AIDS in Haiti, “vertical programs” can have substantial, positive collateral effects in strengthening health systems (7).