Posted by: davidjolson | 12/06/2010

Beginning today, the promise of a world without meningitis

This guest blog was written by Monique Berlier, head of communications for the Meningitis Vaccine Project, a partnership of PATH and the World Health Organization.

In 1996 and 1997, the largest meningitis epidemic in African history swept across sub-Saharan Africa, killing 25,000 people. For ministers of health in meningitis belt countries stretching from Senegal in the west to Ethiopia in the east, their deaths were the final blow in a century-long battle with epidemic meningitis. For three decades, they’d fought back with imperfect polysaccharide vaccines, but the epidemics were growing more frequent — and more deadly. The ministers knew they needed a vaccine developed specifically for Africa, and affordable for Africans.

This morning in the West African country of Burkina Faso, the ministers’ hopes for a vaccine with the potential to end epidemic meningitis are being realized. The first mass vaccination campaigns with MenAfriVac, a conjugate vaccine that holds the promise of protecting millions from group A meningococcal meningitis, have begun. The New York Times published this story yesterday on this new era in African health.

The introduction of the vaccine signifies many milestones for the region. It’s the first time in history that a vaccine has been specifically designed for Africa. It’s the first vaccine introduced in Africa before reaching any other continents. And it’s the first time mothers will not have to live in fear of a meningitis epidemic taking away their children and destroying lives.

For the global health community, the vaccine’s introduction is a milestone, too. It illustrates how solutions to seemingly intractable problems can be brought within reach when science, will, and resources join forces.

In response to requests from African ministers, global health leaders came together in 2000 to discuss developing a new, more potent, and low-cost vaccine to fight group A Neisseria meningitidis, the leading cause of epidemics in the meningitis belt. They agreed such a vaccine was possible, and a priority. A year later, the Bill & Melinda Gates Foundation provided a ten-year grant to establish the Meningitis Vaccine Project (MVP), a partnership between PATH and the World Health Organization that would focus on the development, testing, licensure and widespread introduction of a vaccine.

The project’s success hinged on the cooperation of a wide range of partners, including experts in pharmaceutical and clinical trials; consultants with expertise in carbohydrate chemistry, vaccine regulatory issues, and pharmaceutical development; and an advisory group made up of senior African public health officials that advised MVP on the choice of clinical trial sites and the design of trials.

One crucial partnership was established in 2002, when MVP began working with the Serum Institute of India Ltd., a developing-country vaccine manufacturer. Together, the partners put together an innovative product development plan — where the raw materials come from one source, the technology from another, and the manufacturing capability from a third — to produce MenAfriVac at less than U.S. $0.50 a dose.

In all, development of MenAfriVac cost less than one-tenth the US $500 million investment usually required to bring a new vaccine to market, and was accomplished in just under ten years.

For mothers and fathers in Burkina Faso — and in Mali and Niger, where the vaccine is also being introduced this winter — the value of the new vaccine isn’t measured in dollars. It’s measured in the number of children growing up free from the disability and death that epidemic meningitis once threatened.

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