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A vaccine for Africa
AFRICAS 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 worlds
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.
destruction: Africas 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.
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