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June 2001

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A vaccine for Africa

AFRICA’S much-feared epidemics of meningitis could be consigned to history within a decade with the help of an ambitious project that aims to develop and introduce more effective vaccines tailored to the needs of the continent.

The leaders of the project, the World Health Organization and the Program for Appropriate Technology in Health (PATH) are in discussion with vaccine manufacturers now and hope to see the first vaccines licensed between 2003 and 2006. The partnership has been given financial muscle with a grant of US$70 million from the Bill & Melinda Gates Foundation, announced on 30 May.

If the project succeeds, it could be a template for the development and introduction of vaccines against other diseases that primarily affect the world’s poorest peoples. As well as bringing candidate meningitis vaccines out of the laboratory and through field trials, the partnership aims to overcome problems of licensing products, financing their purchase through global mechanisms, and ensuring an adequate supply to meet needs. "I hope this project could become a model for other vaccines for developing countries," says Luis Jodar at WHO.

Swathe of destruction: Africa’s meningitis belt

Meningococcal meningitis attacks a swathe of 18 countries across Africa (see Map), with irregular and unpredictable epidemics that wreak havoc on fragile health systems. The disease is feared more than HIV or malaria, even though it kills fewer people. In the worst recent season, in 1996, about 200,000 cases and 20,000 deaths were reported, though actual numbers were probably higher. In the past year alone, some 4000 died, and thousands more were left with permanent disabilities.

Of five strains, or serotypes, of meningococcal meningitis found worldwide, serotypes A and C are the two most likely to cause epidemics. An A/C polysaccharide vaccine exists, but it does not prevent the spread of infection between carriers and so cannot protect whole populations. Also, its protection may be shortlived. As a result, mass vaccination campaigns must be organized every time an epidemic occurs. The Meningitis Vaccine Project aims to develop A/C conjugate vaccines which would provide lasting immunity and interrupt the spread of infection. The technology for making these vaccines has been available for a decade, and conjugate vaccines are licensed against other serotypes found in industrialized countries. In contrast, manufacturers had no incentive to make a vaccine against serotype A, which is restricted mainly to Africa. The returns on investment were perceived as too low.

Officials from health ministries in at least eight African countries told WHO what they needed in a vaccine. "This is a tailor-made vaccine for Africa, designed by Africans," says Dr Jodar.

Further reading

Phyllida Brown


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