Ending An Epidemic: The Story of the Meningitis A Vaccine
May 23, 2012
Meningitis may not be entirely unfamiliar to most of you. Maybe you’ve heard of the disease or had experience with it. But epidemic meningitis is an entirely different scenario. In Africa, epidemic meningitis emerges during the dry season in the so-called meningitis belt, caused by a bacterium that is generally sporadic in other parts of the world. Children and young adults show fever, signs of collapse, and may even slip into a coma as the bacteria invades their blood and the space around the brain. In the Sahel, in sub-Saharan Africa, it can cause 1000 cases of meningitis in one city—stopping commerce, closing schools, and overwhelming health care resources.
Our proposed intervention to get rid of this disease in this region of the world, over a decade ago: Africa needed a modern vaccine targeted to the needs of the population, as rapidly as possible.
The challenge, of course, was tremendous. We had to figure out how to get the vaccine made at a very low price, but at a large scale sufficient to vaccinate half the population of sub-Saharan Africa.
I’m proud to say we’re well on our way.
This month, I had the honor of witnessing the awarding of the Sabin Gold Medal to leaders of this effort: Marc LaForce and the MenAfriVac™ WHO-PATH project, for the development and implementation of a meningitis vaccine to prevent epidemics in sub-Saharan Africa. The Sabin Gold Medal is the highest scientific honor given by the Sabin Vaccine Institute, and commemorates the legacy of the late Dr. Albert B. Sabin, the man who developed the first oral polio vaccine.
Thanks to the commitment from amazing individuals from PATH, the World Health Organization (WHO), the Serum Institute of India, the Centers for Disease Control (CDC), SyncoBio, academia, and others, in partnership with the Gates Foundation, this idea conceived over ten years ago has become a reality.
A Meningitis A vaccine needed to cost less than 50 cents, so leaders in these countries could afford to sustain immunization to new infants and as quickly as possible.
Why had this not happened before? In Africa, the price for the vaccine needed to be quite low, and the scale of supply needed to be high. These are the wrong numbers for classic, for-profit, pharmaceutical company engagement. It really needed push funding to make it happen.
Enter Marc LaForce, the leader of the project for the next decade. Among his first steps was a key action: he went to the countries affected by the meningitis epidemic, and to the WHO African Regional Office and asked them directly what they wanted to see in a vaccine.
The answer they gave him was clear: it needed to cost less than 50 cents, so they could afford to sustain immunization to new infants; and they wanted a Meningitis A vaccine as quickly as possible, since most epidemic meningitis was due to this strain.
After an incredible journey, over the next decade the trials were conducted in India and Africa, and a vaccine was licensed in India and introduced in 2010 into the first three countries in Africa: Burkina Faso, Mali, and Nigeria. More than 50M doses have been distributed so far.
To extend these benefits to other countries, the Global Alliance for Vaccine and Immunization (GAVI) has committed resources to support immunization of the target population: children and young adults from the age of one year old up to 29 years old. And these countries have committed to vaccinating the new generations of babies as they are born.
This story is “Global Health” writ large: A problem identified, a solution created, and ultimately, a community immunized. Leadership rose to the occasion, conquering the usual barriers of financing, language, bureaucracy, and complexity. Ultimately, there are many parents of this success.
It won’t make a lot of money, and the success of this partnership may go largely unrecognized in the midst of the global agenda. But the parents of those children waiting in the heat in Burkina Faso for the first doses of vaccine were only aware that they were getting something they really needed: effective prevention.