New meningitis vaccine hopes to stop epidemic

Meningitis is one of the diseases that the under-developed world has little prevention against. The disease causes an annual epidemic across north-central Africa. A new low cost vaccine hopes to prevent the meningitis illnesses when it begins distribution next year.

From Nature News, writer Declan Butler describes the new vaccine and how it was brought from idea to reality.

This year will be different. Millions will receive a new vaccine, MenAfriVac, that promises protection against the meningococcal bacterium Neisseria meningitidis. It is the culmination of ten years' work by an international consortium to develop a vaccine at a price low enough for massive use in Africa: just US$0.40 a dose. "MenAfriVac is a fantastic initiative," says Andrew Riordan, a meningitis expert at Alder Hey Children's NHS Foundation Trust, in Liverpool, UK. "For the first time, we may be able to prevent these huge epidemics."

The Meningitis Vaccine Project (MVP), led by the World Health Organization (WHO) and PATH, a non-profit body based in Seattle, Washington, was born in 2001 after a particularly bad epidemic in 1996–97 caused 250,000 cases and 25,000 deaths (see 'Epidemic cycle'). Commercial manufacturers in developed countries could not produce the vaccine at such a low target price, according to Marc LaForce, director of the MVP. So the consortium did the research itself, and contracted the Serum Institute of India in Pune to make the vaccine. The entire research and development cost of the project was just $70 million — five to ten times less than typical vaccines. LaForce hopes that the MenAfriVac model can be applied successfully to other vaccines.

During next month's campaign, backed by the WHO and the United Nations Children's Fund (UNICEF), the government of Burkina Faso will vaccinate everyone aged 1–29 — the group hit hardest by the disease, numbering 12.5 million people. Mali and Niger will each vaccinate 4 million people in the same age bracket.

Meningitis A epidemics cause fewer cases and deaths in Africa than AIDS or malaria, but this masks its huge social and economic toll in those countries. "When the epidemic arrives, the entire community shuts down," says LaForce. The disease — which infects the meninges, the membranes surrounding the brain and spinal cord — begins with mild symptoms of stiff neck, high fever, confusion and headache, but can kill within 48 hours. Of those infected with meningococcal meningitis A, 5–10% die and 10–20% of survivors are left with severe disabilities.