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Tailor-made vaccine set to banish Africa's meningitis epidemics

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Barely five years after the team began rolling out a tailor-made vaccine in Africa’s “meningitis belt”, the disease has all but disappeared there and the Meningitis Vaccine Project (MVP) is closing down after pioneering what may be a model for tackling infectious diseases in developing countries.

“We have not seen a single case among vaccinated populations …,” said Marie Pierre-Preziosi, MVP’s director, “and transmission has stopped.”

The tale of MenAfriVac, made by Serum Institute of India and costing just 50 U.S. cents a shot, elicits hopeful comparisons with the current rush to develop a vaccine against Ebola:

A deadly disease needed tackling quickly at a price affordable to some of the world’s poorest people; a committed group of scientists, drugmakers and philanthropists got together and developed a cheap, simple vaccine specifically for Africans; it was tested, trialled and deployed in record time; and in a matter of years, thousands of lives have been saved.

On Friday, the World Health Organization (WHO) authorised MenAfriVac for use in routine child immunizations in Africa, establishing it as part of everyday healthcare and bringing an end into sight for a disease that has plagued Africa for more than a century.

BRAIN DAMAGE AND DEATH

Before MenAfriVac’s introduction in 2010, people in a belt stretching from Senegal to Ethiopia were regularly afflicted by epidemics of the ‘A’ strain of meningitis.

Meningococcal meningitis infects the thin lining surrounding the brain and spinal cord. It can cause severe brain damage, deafness, epilepsy or necrosis and, if untreated, is fatal in 50 percent of cases.

One of Africa’s worst recorded outbreaks was in 1996-97, when some 250,000 were infected and more than 25,000 died in a few months.

An epidemic in Nigeria in 2008-09 saw 56,000 cases, almost three times the current total of Ebola cases in West Africa.

Yet five years on, meningitis A is rare in Africa. Jean-Marie Okwo-Bele, director of the WHO’s immunisation department, called the introduction of MenAfriVac a “stunning success”.

In 2010, he told a briefing of the “fear in the population” during seasonal outbreaks in the Democratic Republic of Congo, saying: “You can see empty streets because people are so afraid to be in contact with each other.”

CHEAPER AND BETTER

Back then, the available meningitis vaccines were broad-spectrum, targeting four strains, A, C, Y and W-135. They were also expensive, so in Africa were generally limited to emergency immunisation campaigns that were often too little, too late.

So African leaders urged global health experts to make something better – a vaccine costing no more than 50 U.S. cents that could specifically protect against the meningitis A that was claiming so many lives.

“African health officials told us: ‘Don’t come with a vaccine we cannot afford, because that would not be a solution’,” Pierre-Preziosi said.

In record time, with focused drug research, committed partnerships and funding from the Bill & Melinda Gates Foundation, MVP bypassed big pharma firms and approached a cheaper generic drugmaker, Serum Institute of India, to develop a monovalent, or single-strain, meningitis A shot.

It is the first vaccine made specifically for Africa, and the first not to need constant refrigeration, allowing it to be transported to remote areas in hot regions.

Since being introduced in Burkina Faso in 2010, it has been given to 215 million people across Benin, Cameroon, Chad, Ivory Coast, Ethiopia, Ghana, Mali, Niger, Mauritania, Nigeria, Senegal, Sudan, Togo and Gambia.

MVP’s website features a valedictory film clip.

“It’s quite short,” says Pierre-Preziosi. “But in it, you will see the meningitis belt disappear.”

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