Speeding up what is usually a years long process, the World Health Organization (WHO), GlaxoSmithKline and the Bill & Melinda Gates Foundation are making a new meningitis vaccine available to African countries just months after an emerging epidemic of a new strain of the disease was discovered. The ACW135 vaccine will cover the typical meningitis strains found in Africa (A and C) as well as the W135, a strain found only in sporadic cases on the continent until last year, when it affected 14,453 people and killed 1,743 in Burkina Faso.
100,000 doses of the new vaccine are being shipped to Burkina Faso, where 1,349 cases of W135 meningitis have already been confirmed, out of which 244 people have died.
The overall initial supply of the vaccine — 3 million doses — will be made available at reduced cost for the African meningitis belt (an area comprising 21 countries stretching from Ethiopia in the east to Senegal in the west), in response to need over the coming months.
“The record time in which we've come up with a vaccine and are making it available to those who need it is a testament to the fact that public-private partnerships can work for the betterment of health,” says Gro Harlem Brundtland, Director-General of WHO.
Meningitis is a killer disease affecting mostly children. Fever, nausea and headache can progress rapidly to cause serious neurological damage, deafness, coma and death. Unless treated, up to half of those infected will die. Even with treatment, as many as 20 per cent of patients do not survive.
Meningitis outbreaks occur almost every year during the dry season in the African meningitis belt. The crucial epidemic period is usually in the first months of the year. In 2002 alone, there were at least 44,280 cases and 5,531 deaths reported to WHO's surveillance systems in the African region.
“It is possible that the W135 strain will not remain contained in Burkina Faso, but that it will spread to other countries in the meningitis belt, just like the A strain did 15 years ago,” explains Daniel Tarantola, Director of Vaccines and Biologicals at WHO. “But we have great hopes that this newly formulated vaccine will save many lives and we are working on other vaccines that may, in the years to come, break the cycle of death and illness due to meningitis in this area.”
In response to the unexpected W135 outbreak in 2002, WHO sounded the alarm to the pharmaceutical industry, asking their assistance to make a trivalent vaccine available at an affordable price. GSK responded favourably and developed the vaccine in just a few months. The Gates Foundation granted most of the necessary funds to buy the vaccine.
Until now, only a quadrivalent vaccine covering the W135 strain was available, but its cost of between US$ 5 and US$ 50 per dose meant that it was out of reach of those countries where it was most needed. The new vaccine is available at US$ 1.50 per dose once delivered to countries in the meningitis belt taking part in an impact evaluation due to begin this month. The Belgian National Regulatory Authority has already licensed the vaccine for international use.
The vaccine is being distributed through the International Coordinating Group on Vaccine Provision for Epidemic Meningitis Control (ICG), which was created by WHO in 1997. Countries wishing to obtain the vaccine must submit a formal request to the ICG, which also includes the International Federation of Red Cross and Red Crescent Societies, Médecins Sans Frontières and UNICEF. The requests are reviewed and vaccine distributed only to those countries which meet key epidemiological and operational criteria established by the ICG, which can be found on outbreak@who.int