AFRICA: New meningitis vaccine nears debut

Saturday, March 14, 2009

A new vaccine that promises to eliminate meningitis in Africa will be rolled out in a mass campaign in West Africa this year, according to the UN World Health Organization (WHO).

Twenty-five million doses of the meningococcal A, or MenA, vaccine are currently in production in India and the drug is expected to be introduced in Burkina Faso late 2009.

“This is the beginning of the end of the disease,” said Marc LaForce, the director of the Meningitis Vaccine Project (MVP), an initiative of WHO and the non-profit PATH that has been developing the vaccine since 2003.

The vaccine currently used in the region spanning from Senegal to Ethiopia – called the ‘meningitis belt’ for its vulnerability to deadly outbreaks – offers at most two years of protection, according to MVP.

While the disease is more deadly in the meningitis belt than anywhere else in the world, there have been no prevention vaccines for the strain found in Africa- until now, according to clinical trials with MenA.

Recent studies with patients age one to 29 in India, Mali, Senegal and The Gambia have shown that the new vaccine will provide long-term protection. Lead researcher LaForce has said the drug “will allow the elimination of the meningococcal [meningitis] epidemics that have afflicted the continent [Africa] for more than 100 years.”

Months away from the vaccine’s US$29-million donor-financed debut in three countries – Burkina Faso, Mali and Niger – LaForce told IRIN the deadly bacteria that attack the spinal cord and brain lining cannot be wiped out overnight.

“Look at polio and how long it took to eliminate that. We are looking at 10 years at least [for elimination],” he said.

More than 45 years after the polio vaccine was licensed, there were still more than 1,600 infections worldwide in 2008, according to WHO – down from 350,000 cases 20 years ago.

LaForce told IRIN the MenA vaccination campaign’s goal is to reach “herd immunity”, in which if at least 70 percent of the population is immunised, then the entire population is protected.

When asked if people who might refuse vaccinations could thwart herd immunity, LaForce said the response has been “tremendous” in clinical trials to the vaccine and that “70 percent [immunisation] coverage will not be hard to reach.”

LaForce has said that “a single case of meningitis can drive a family into a spiral of poverty from which they may never recover.”

Even with antibiotic treatment, at least 10 percent of people stricken with meningitis die and 20 percent are left with permanent disability including mental retardation, deafness or amputation, according to WHO.

The international health agency reports more than 9,500 cases thus far in 2009, including an outbreak in a camp for displaced persons in Darfur, Sudan where aid workers have recently been ordered to leave.

WHO aims to immunise 250 million people in the meningitis belt by 2015. The Global Alliance for Vaccine and Immunization (GAVI) has agreed to create an emergency stockpile of the MenA vaccine starting in 2011 with an initial investment of $55 million.

WHO has pledged to “fast-track” approval of the vaccine as soon as it is licensed in India, according to the director of WHO’s Initiative for Vaccine Research, Marie-Paule Kieny.

Kieny told IRIN the vaccine is scheduled to become a routine childhood immunisation by 2012.

Potential obstacles to mass immunisation are new meningitis strains and inadequate funds to continue beyond the three roll-out countries, according to Kieny.

MenA is expected to cost governments 40 cents per dose; current meningitis vaccines cost up to $1.58, according to WHO.

LaForce said the challenge in developing MenA has been in part financial. “These are the poorest areas in the world. Large pharmaceuticals were not interested in producing a specific product for Africa.”

Bill & Melinda Gates Foundation has funded MVP’s creation, research and development since 2001.