NEWS - November 2002
Awaiting help: one of the children affected by Burkina Faso's 2002 epidemic. Untreated, half of those infected will die
Vaccine deal for feared strain of meningitis `is imminent'
WITH two months to go before the start of the meningococcal meningitis season in Africa, WHO, UNICEF and industry are in the final stages of negotiations to begin using a vaccine that should protect against a virulent form of the disease.
The vaccine is based on three strains of Neisseria meningitidis. Existing vaccines used in the meningitis "belt" of 21 African countries protect against the two most common of these strains, or serogroups, called A and C. The new vaccine is designed to immunize also against a third serogroup, W135, which until 2002 had appeared only sporadically in Africa, but this year caused an epidemic in Burkina Faso. Some 12,000 people were affected and 1,500 were killed. At a meeting in Ouagadougou in September, African governments and others issued an urgent call for an affordable vaccine that also protects against the new W135 serogroup.
There is already a licensed W135-containing vaccine sold in industrialized countries, but it costs up to $50 per dose. The new trivalent "ACW" vaccine is expected to be made available at about $1 per dose, but is currently unlicensed. Until its manufacturer, GlaxoSmithKline in Belgium, obtains a licence, the vaccine can be used only for study purposes, with the approval of the regulatory authorities in the African countries that need it and in Belgium.
WHO and its partners are now preparing a protocol for studies to measure the vaccine's impact in the event of an outbreak. Countries' own ethical review boards will then examine it.
Unless the feared epidemics fail to materialise, demand for the vaccine is almost certain to outstrip supply at first. By the time the meningitis season begins in late January, the manufacturer will be able to provide only 3 million doses, although it can scale up production during 2004. Criteria must be agreed in advance to help decide where the vaccine should be used first if several outbreaks occur, said Dr Maureen Birmingham at WHO's vaccines and biologicals department in Geneva.
WHO, the International Federation of the Red Cross, Médecins sans Frontières and UNICEF last week launched an appeal to donors to pay for a stockpile of meningitis drugs and vaccines for Africa. Equally important, said Birmingham, will be investment to improve the at-risk countries' surveillance and response capacity to ensure rapid detection of an epidemic, laboratory capacity to confirm it, and a rapid response mechanism to minimise the number of cases and deaths.
Immunization Focus November 2002 - Contents