MenAfriVac to help health workers eliminate meningococcal A epidemics

More than 12 million people in Burkina Faso to receive new vaccine by end of year

The West African nation of Burkina Faso today became the first country to begin a nationwide campaign to introduce a new meningitis vaccine that promises to rid the entire region of the primary cause of epidemic meningitis. The first vaccine designed specifically for Africa, MenAfriVac is expected to help health workers eliminate meningococcal A epidemics in the 25 countries of the meningitis belt, stretching from Senegal in the west to Ethiopia in the east.

An affordable solution

Priced at less than US$ 0.50 per dose, MenAfriVac is a highly affordable solution to one of the region's biggest health problems. Using a unique public-private partnership model, the development of MenAfriVac cost only US$ 50 million - a fraction of the amount usually required to develop and bring a new vaccine to market.

450 million people at risk

For more than 100 years, sub-Saharan Africa has suffered from epidemics that exact a terrible and deadly toll. As many as 450 million people are at risk from the disease across Africa. Major group A epidemics occur every 7-14 years and are particularly devastating to children and young adults. The sickest patients typically die within 24 to 48 hours of the onset of symptoms, and of those who survive, 10-20% suffer brain damage, hearing loss or a learning disability. In 2009, the seasonal outbreak of meningitis across a large swathe of sub-Saharan Africa infected at least 88 000 people and led to more than 5 000 deaths.

The beginning of the end of a disease

"This historic event signals the beginning of the end of a disease that has brought sickness and suffering to generations of Africans," said Seydou Bouda, Minister of Health of Burkina Faso. "The unique collaborative effort that has made this breakthrough possible is both testament to the commitment of ministers of health across Africa and the relentless dedication of our technical partners in developing a vaccine that specifically meets the needs of countries in the African meningitis belt."

Developed by the Meningitis Vaccine Project (MVP)-a partnership between WHO and PATH, with support from the Bill & Melinda Gates Foundation - the new meningococcal A conjugate vaccine MenAfriVac provides African health authorities, for the first time, with an affordable, long-term solution that protects even young children against meningitis A (group A Neisseria meningitidis).

A unique development model

"The model created through the development of this vaccine is groundbreaking and could not have been accomplished without the joint efforts of the African ministers of health and the many partners and collaborators around the world," said Dr Christopher J. Elias, President and CEO, PATH. "MenAfriVac may well serve as a model for developing vaccines in the future to combat other deadly diseases in low-resource settings."

The new vaccine has several advantages over vaccines currently used to combat meningitis epidemics in Africa: it protects children as young as one; and it is expected to both protect from the disease for significantly longer than the vaccine now used to combat epidemics, and to reduce infection and transmission. Reduced transmission in turn protects the larger community, including family members and others who have not been immunized.

"From day one, the development of this vaccine has been a collaboration between industry, institutions, and individuals driven by public health needs," said Dr Marc LaForce, Director of the Meningitis Vaccine Project. "The successful development of a vaccine in less than a decade is almost unheard of."

The rapid development of the vaccine is in large part due to the commitment of the Serum Institute of India, Ltd., the vaccine manufacturer. Africans have in the past waited as long as 20 years for a vaccine to travel from the industrialized north to the nations of the south. In this case, MenAfriVac will be introduced in Africa before it is distributed anywhere else.

The process of developing the new vaccine and planning for its introduction has also helped strengthen systems in Africa for disease surveillance, clinical development, pharmacovigilance and vaccine logistics. Clinical trials, carried out in the Gambia, Ghana, India, Mali, and Senegal, beginning in 2005, have shown the vaccine to be safe and highly effective. Indian regulatory authorities granted marketing authorization for export and use of MenAfriVac in December 2009. In June 2010, the vaccine was prequalified by WHO, which guarantees that the vaccine meets international standards of quality, safety, and efficacy.

A sound investment

"In fewer than 10 years, we have overcome obstacles that have in the past seemed insurmountable," said Dr Margaret Chan, WHO Director-General. "With a one-time investment to vaccinate populations in all countries of the meningitis belt, nearly 150 000 young lives could be saved by 2015, and epidemic meningitis could become a thing of the past. This is within reach. We must not fail."

If MenAfriVac is introduced throughout sub-Saharan Africa, the resulting reduction in cases of meningitis is expected to free up more than US$ 120 million in the period up to 2015, money from national budgets which would otherwise be spent on medical costs for diagnosis and treatment. These funds can then be brought to bear on other problems of disease and poverty that weigh so heavily on the region.

The GAVI Alliance has thus far contributed over US$ 85 million to the effort to eliminate meningococcal A meningitis in Africa. Yet, the full promise of the vaccine, to protect people throughout the African meningitis belt, can only be realized if an additional US$ 475 million is mobilized.

"GAVI is delighted to be contributing to funding the new vaccine's introduction" said Helen Evans, GAVI Alliance Interim CEO. "We very much hope to be able to support the further rollout of MenAfriVac, so that by 2015 populations in all 25 countries of the meningitis belt will be vaccinated against meningitis A."

The introduction of MenAfriVac in Burkina Faso will be closely followed by introduction in Mali and Niger, two other hyper-endemic countries in the meningitis belt. Vaccine introduction in these three countries has been made possible through the support of a number of funding and technical partners, including the Michael & Susan Dell Foundation, Médecins sans Frontières, and UNICEF. "Having procured the vaccine, UNICEF is working with the Ministry of Health of Burkina Faso and local communities to ensure that this extraordinary campaign is a success," said Dr Gianfranco Rotigliano, Regional Director of the UNICEF Regional Office for West and Central Africa.