Countries in the African meningitis belt are being faced with a new threat, the W135 strain, which has already killed 1,400 people in Burkina Faso in the first half of 2002. However the response from drug manufacturers to the developing emergency is minimal. In particular, Aventis Pasteur has not only failed to provide any possible vaccine for the new strain but have also increased the price, and then limited the availability for a humanitarian reponse of another vaccine where they are the sole provider.
Leading international experts on the disease agree on the need to prepare for potential W135 outbreaks in Africa. Since early December 2002, an increasing number of cases (123 during week 51 and 140 during week 52) have been recorded in Burkina Faso. The data seems to suggest that an epidemic might be on its way, with a potential to spread on to neighbouring countries. Thousands of lives might be lost in the next few weeks and months unless emergency measures are taken.
The ICG (the International Coordination Group for meningitis vaccines) have launched an appeal of euro 10 million to build a stockpile of vaccines and treatment to begin to tackle the next epidemic season adequately. MSF is working together with WHO and other ICG partners to assist the countries affected to prevent and alleviate the consequences of such an outbreak.
With any such outbreak having an immediate and fatal impact on the people we are currently assisting in the meningisits belt, MSF is monitoring the development of the meningitis fund as well as the development and provision of necessary vaccines by manufacturers.
But not everyone is doing all they can to prevent a crisis. In some instances, the action taken is more a step backward than an advance, given the current situation. In one instance, one vaccine manufacturer appears to be unfairly profiting financially from the pending emergency.
Even in the face of the recent W135 outbreak and subsequent international negotiations between the World Health Organisation (WHO), its partners such as MSF, and the African governments involved, the vaccine manufacturer Aventis Pasteur did not actively participate in developing a vaccine against W135, whereas GlaxoSmithKline came forward with a trivalent vaccine which can be used during the next epidemic season.
As the sole provider of a bivalent vaccine (A+C) for African countries, Aventis Pasteur seems to be benefiting from the situation rather than seeking ways to contribute to a solution. The price of the bivalent vaccine has recently been increased; first in 2001 from US$0.15 to US$0.24 per dose, then to US$0.28, an 87% increase in total, as well as setting limits for the latter price, with a ceiling fixed at 3,5 million doses only. After 3.5 million doses purchased in one season, humanitarian actors are obliged to pay market prices that range between $US0.30-0.40 per dose. Yet even in a market economy, prices for larger amounts should be lower than for small quantities.
In a letter from Dr Laturnus (of Aventis) to WHO dated December 16 2002, Aventis Pasteur stated the company was refusing to make available to the ICG the necessary 10 million doses of vaccine A+C requested by WHO.
In addition, Aventis Pasteur recently announced they wanted to annul a previous arrangement to maintain a revolving stock of the bivalent vaccine for ICG, and return a prepayment to WHO.
The above actions further deteriorate the international response to meningitis outbreaks in Africa. All this is happening while the ICG members are struggling to raise the funds necessary for a appropriate response to the next epidemic.
Commercial companies can and will be measured not only by their return on investment but also by the level of social responsibility they demonstrate.
As a large multinational company, Aventis Pasteur is no exception. Being the sole manufacturer of bivalent vaccines for Africa entails an equivalent responsibility. Aventis Pasteur's activities will doubtless be under public scrutiny during the next meningitis outbreak.