A cheap new vaccine against Meningitis A recently approved by the World Health Organization (WHO) is being described as a “game changer” that will bring hope to the 430 million people at risk of the disease in the so-called Meningitis Belt, in Sub-Saharan Africa, but only if there is enough financial backing.

The new vaccine is the result of a collaboration between the Meningitis Vaccine Project (MVP, a partnership between the WHO and the non-profit organization PATH which is funded by the Bill & Melinda Gates Foundation), and an Indian manufacturer, the Serum Institute of India who will make the vaccine at an agreed starting price of 0.40 US dollars (30 UK pence) per dose.

The new vaccine will change the game in Africa, said Dr Cathy Hewison, medical advisor at Médecins Sans Frontières (MSF), because it offers four times greater protection and lasts much longer, which means it can be used to prevent epidemics rather than just respond to outbreaks like the current vaccine.

“In 2009, MSF vaccinated more than 7 million people for Meningitis A, but until now we have been confined to emergency response, trying to slow and stop epidemics,” Hewison said in a statement.

According to MSF, final product affordability and medical needs drove the development of the new vaccine. Dr Tido Von Schoen-Angerer, director of their Access to Essential Medicines campaign said:

“This is a complete revolution compared to the usual patent-based, profit-driven model.”

He said the developers focused on keeping the vaccine affordable, tailoring it to suit the medical needs of developing countries.

“This is a striking contrast to the blockbuster vaccines developed by the largest commercial developers for Western markets, that fetch extremely high prices and aren’t produced with developing country needs in mind,” he added.

Research suggests that Africa has been experiencing meningitis epidemics on and off for the last 100 years.

The disease is most prevalent in the Meningitis Belt that stretches from Senegal and the Gambia in the West to Ethiopia in the East, with epidemics occuring during the dry season from December to June. An epidemic wave can last up to three years, dying out during the rainy season.

The size of the epidemics in Africa is staggering: in the 1990s when there was a Meningitis C outbreak in the UK it killed 1,000 people, meanwhile at the same time, a Meningitis A outbreak killed more than 100,000 people in Africa.

Epidemics of such proportions place a great burden on the health systems of the countries in the Meningitis Belt, where some communities have reported infection rates as high as 1 in 100 people (most African epidemics report rates of 100 to 800 per 100,000).

Two alarming new patterns underpin the urgency to bring in this new vaccine: the period between epidemics appears to be getting shorter and the belt appears to be extending further south, towards Angola, Burundi, the Democratic Republic of the Congo, Rwanda (Great Lakes region), and Zambia, although this could be a result of increased surveillance says MVP.

Mass roll out of the new Meningitis A vaccine will start this autumn in Mali, Burkina Faso and Niger with backing from Global Alliance for Vaccines and Immunization (GAVI) and WHO.

But rolling out to the rest of the Meningitis Belt will be a challenge: MSF suggests international leadership is needed to mobilize the 475 million US dollars of funds required, as it is unlikely that the targeted countries will be able to shoulder such a burden on their own.

Dr William Perea, a WHO meningitis expert told Associated Press that while this sounds like a lot of money, we have to consider the value for money in terms of public health impact:

“We’re spending hundreds of millions of dollars trying to stop a petrol leak in the Gulf,” said Perea.

“Don’t tell me we can’t find the money to pay for something that is a real public health breakthrough,” he added.

Perea said that meningitis outbreaks also have knock on effects in other areas. When epidemics occur, for four or five months the health systems in the affected countries come to a halt while health workers focus on meningitis patients.

He said “meningitis will probably be history” if the money and resources can be found to make the vaccine available to the entire area.

Sources: MSF, WHO, MVP, AP.

Written by: Catharine Paddock, PhD