The end of the rainy season in Africa could trigger the worst meningitis epidemic to hit the continent in a decade, which the international community is poorly prepared to handle, the World Health Organization warned on 9 October.

At least 80 million people living in 21 countries from Ethiopia in East Africa to Mauritania in West Africa that make up a region often called Africa’s ‘meningitis belt’ might need to be injected with preventative vaccines this year, WHO said at an emergency meeting held in the Burkina Faso capital Ouagadougou.

Last year just 7 million doses of vaccines were available to the entire region because of funding shortfalls and a global deficit in the production of the cheaper vaccines usually used in Africa as European drug manufacturers have focused on producing newer, long-lasting but more expensive vaccines.

The meningitis virus, which usually reaches epidemic levels in the meningitis belt between December and May, could be especially severe this year as the region is heading toward the peak of a 10- to 12-year cycle of meningitis crises, health forecasters say.

“The number of cases has increased in the last two seasons and we are likely to have major epidemics in a context of vaccine shortages,” Dr Deo Nshimirimana, Director of the Communicable Disease Control Department at WHO Africa office told IRIN. “We need to educate everybody so that we can be prepared in case of an epidemic.”

An estimated total population of between 300 million and 400 million people live in the meningitis belt countries, the vast majority of them in isolated, rural areas, often far from roads or health centres. Between 1995 and 1997, the last time there was a major epidemic in the region, at least 25,000 people died and 250,000 people were infected.

From December to May last year 53,000 cases of meningitis were reported and an estimated 4,000 people died across the region.

The countries affected are mostly extremely poor and have desperately under-resourced health systems. In many of the countries, governments rely on foreign donors to prop up basic health infrastructure even when there is not a crisis.

WHO has asked donors to provide US$14 million to purchase 12 million doses of vaccine and injection materials, and to cover transport, storage and insurance costs. WHO also wants to strengthen surveillance and diagnosis capacities in the region, which includes several of the poorest countries in the world.

“The partners have been receptive to our appeal and to the stakes,” Nshimirimana said. “They have agreed to lobby at their headquarters.”

The 12 million doses – a minimum, according to WHO – will be pre-positioned for response in case of epidemics. Additionally, WHO wants to set up a security stock of 500,000 vaccine doses in each of the countries of the meningitis belt.

“I think this meeting is very important because the budgets of African countries mean left alone they cannot support the fight against meningitis,” Burkina Faso’s health minister Alain Yoda said at the opening of the WHO meeting. Burkina Faso, where nearly 26,000 cases of meningitis were recorded last year and 1,732 people died, needs six million doses, Yoda said.

Semi-arid Sahelian countries are hit each year by outbreaks of meningitis during the dry seasons between December and June when strong, dust-laden winds and cold nights make people more prone to respiratory infections. The meningitis bacteria is transmitted by sneezing or coughing.

Meningitis is an infection of the thin lining around the brain and spinal cord. Even when meningitis is diagnosed early and adequate therapy is available, between 5 and 10 percent of patients die, typically within 24 and 48 hours of experiencing the first symptoms. Many thousands of survivors live on with brain damage, hearing loss, or learning disabilities.

UN agencies and non-governmental organisations at the Ouagadougou meeting included the UN children’s fund, the European Commission Humanitarian Aid Office, USAID, Medecins Sans Frontiers, the World Bank and the US Centers for Disease Control and Prevention.