African countries to introduce new meningitis vaccine
Sunday, September 07, 2008
Health ministers from countries of the African meningitis belt today committed themselves to introduce a highly promising candidate meningitis vaccine. The vaccine is designed to prevent periodic epidemics of the deadly disease in these countries.
Meeting at the 58th session of the WHO Regional Committee for Africa, held in Yaoundé from 1 to 5 September, the ministers adopted the Yaoundé Declaration, committing themselves to several actions. They agreed to prepare comprehensive meningitis control plans, including the introduction of the new vaccine once available; to implement meningitis control strategies; to undertake joint action vis-à-vis the threat; to improve information exchange for epidemic response; and to contribute financially to epidemic control activities.
"Several hundred million people are at risk of meningitis in 25 African countries. Many generations have suffered," said Professor Avocksouma Djona, Minister of Public Health, Chad. "On behalf of all affected countries in Africa, today we are collectively committing ourselves to put an end to devastating outbreaks of this disease. We will ensure that this effective new vaccine is made available to populations throughout the Meningitis belt," he said.
Affordable for Africa
The candidate vaccine has several advantages. Priced at just US$ 0.40 per dose, the vaccine produces in both adults and toddlers a higher immune response than the currently available vaccines. In addition, the new vaccine confers long-term protection and induces immunity in certain non-vaccinated persons who live in proximity of those who are immunized, leading to broad community protection.
The meningitis prevention and control strategy that these countries will implement entails introducing the new meningococcal A conjugate vaccine to immunize - between 2009 and 2015 - a population of approximately 250 million people aged 1 to 29 years and 23 million infants living in 25 African countries. It also requires ensuring that adequate quantities of the currently available meningococcal polysaccharide vaccines are available for epidemic response. The latter initiative is important for two reasons: first, to ensure a smooth transition from current epidemic response strategies to a preventive approach and, second, to respond to the threat of non-group A meningococcus meningitis outbreaks (group C or W135).
The meningitis prevention and control strategy was reviewed and endorsed by WHO's Strategic Advisory Group of Experts on Immunization in April 2008 and by the GAVI Alliance Board in June 2008.
'Money well spent'
The new product, conjugate meningococcal A vaccine ("MenAfriVac"), was developed through the Meningitis Vaccine Project, a product development partnership between WHO and the Program for Appropriate Technology in Health (PATH), a non-governmental organization. The project was set up in 2001 with core funding from the Bill & Melinda Gates Foundation.
"A single case of meningitis can drive a family into a spiral of poverty from which they may never recover. By committing to introducing MenAfriVac in meningitis belt countries, African governments will play a pivotal role in eliminating epidemics that have plagued the continent for more than a century, and they will help reduce poverty," said Dr F. Marc LaForce, Director of the Meningitis Vaccine Project.
Children specially at risk
"This is a major development in the prevention and control of cerebro-spinal meningitis in the Sahel countries that will reduce the risk of epidemics currently killing thousands of people in the meningitis belt," said Dr Luis Gomes Sambo, Director of the WHO Regional Office for Africa.
The new vaccine is expected to be introduced starting 2009-10 in Burkina Faso and will be phased into an additional 24 countries between 2010 and 2015, with GAVI support. GAVI funding will also go towards ensuring sufficient stocks of the current vaccines are available for epidemic response during the introduction of MenAfriVac.
Strain behind deadly outbreaks
A phase I clinical trial in adults aged 18 to 35 years was successfully completed in India. Phase II clinical trials of the candidate vaccine have been completed in The Gambia and Mali and showed almost 20 times higher antibody levels in one to two year olds, compared to the existing polysaccharide vaccine. (Follow-up of this trial is ongoing.) Phase II/III clinical trials have been successfully completed in two to 29 year olds in The Gambia, Mali and Senegal.
The vaccine is safe in testing and is manufactured by an Indian company.
An additional large phase III trial will be conducted in India and Mali in early 2009. A phase II study in infants began in Ghana in late August with results expected in 2010. The results of these trials may allow to extend indications for use to infants.