November 14, 2017 |

Continuing the fight against meningitis in Africa

Building a vaccine that will eliminate epidemic disease for good
Crowd of smiling kids.
The MenAfriVac vaccine has protected more than 280 million people in sub-Saharan Africa from group A meningitis. Photo: PATH/ Gabe Bienczycki.

Seven years ago, more than 10 million people in Burkina Faso lined up to receive the first licensed doses of MenAfriVac® and changed the course of meningitis in sub-Saharan Africa. MenAfriVac®, a conjugate vaccine against group A meningococcal meningitis, has since been delivered in mass vaccination campaigns to more than 280 million people across the African meningitis belt, virtually eliminating group A meningitis wherever it has been used.

Woman holding an infant.
Infants and young children are among the most vulnerable to meningococcal meningitis. Photo: PATH/Gabe Bienczycki.

It’s a story that has been told over and over—and for good reason. Group A meningitis was responsible for approximately 80 percent of meningococcal disease in Africa, and it mainly affected infants, children, and young adults. Without treatment, 50 percent of those infected would die within days; even with treatment, one in ten would. Those who survived were often left with severe, lifelong disabilities. But a vaccine changed all of that. The MenAfriVac® story is absolutely worth telling, again and again.

But it’s not the end of the story.

Group A meningitis isn’t the only form of the disease that plagues Africa; groups C, W, X, and Y also circulate and can cause epidemics. In fact, ongoing group C meningitis outbreaks in Nigeria and Niger have infected more than 14,000 people in 2017 alone. These epidemics are illustrative of the unpredictable nature of the disease. Group C meningitis hadn’t been seen in decades, yet here it is.

Protection against group A meningitis is hugely important, but it isn’t the end. To truly eliminate meningitis in Africa, we need a vaccine that shields against all epidemic-causing strains.

Young woman being vaccinated with MenAfriVac.
Recent epidemics of group C meningitis in Nigeria and Niger are a prime example of the need for a multivalent meningococcal vaccine that protects across strains. Photo: PATH/Gabe Bienczycki.

Multivalent meningococcal vaccines designed to protect against multiple strains aren’t novel—they’re already in use in the United States and much of Europe. Many of us received them as a child, or before we went to college. But due to economic hurdles, they’re not practical for use in Africa.

PATH, along with Serum Institute of India Pvt. Ltd., is working to develop a vaccine that is affordable for Africa. We recently began a Phase 2 clinical trial of a multivalent meningococcal vaccine covering groups A, C, W, X, and Y. The vaccine is being studied in toddlers in Bamako, Mali, and comes after encouraging results from a Phase 1 study in healthy US adults. The Phase 2 study will assess safety and immune responses, and it is designed to pave the way for licensure studies down the road.

Vials and other equipment on a laboratory counter.
PATH and partners are working to develop multivalent meningococcal vaccine that, like MenAfriVac, is designed for the economic realities of Africa. Photo: PATH/ Gabe Bienczycki.

Meningitis epidemics are an annual threat in the African meningitis belt. They bring death, disability, and a fundamentally altered way of life. An effective multivalent vaccine would erase that. It would save countless lives; it would prevent untold cases of deafness, paralysis, and loss of limbs; it would help families maintain a level of economic security. A multivalent would lift the cloud of fear that people throughout the meningitis belt live under.

We’ve made huge strides in tackling meningococcal meningitis in Africa. MenAfriVac® helped us to finally imagine a world without meningitis—now we need to keep moving forward and refuse to quit until the job is done. With this project, we have the potential to eliminate meningococcal meningitis from the meningitis belt once and for all.

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  • Mark Alderson is the director of the pneumococcal vaccine and the polyvalent meningococcal vaccine projects in the Center for Vaccine Innovation and Access at PATH.