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Transcript of WHO podcast - 08 September 2008

A new meningitis vaccine is being introduced to prevent epidemics in sub-Saharan Africa. We find out how big a problem meningitis is and how the vaccine will help.

Veronica Riemer: You’re listening to the WHO podcast. My name is Veronica Riemer and this is episode 45.

In this episode, we talk about the introduction of a new vaccine to prevent epidemics of meningitis in sub-Saharan Africa.

In sub-Saharan Africa, some 430 million people, living in the area known as the meningitis belt - which stretches east to west across the continent from Senegal to Ethiopia - are at risk of meningitis. You can contract meningitis at any age, but it affects mainly children and teenagers. In Africa, this has a crippling effect on already vulnerable populations. Even with antibiotic treatment, at least 10% of patients die and up to 20% have serious permanent health problems, such as blindness or deafness.

Health ministers from the African meningitis belt, meeting in Yaounde, committed themselves to introducing a new meningitis vaccine. The vaccine is designed to prevent periodic epidemics of the deadly disease in these countries. This effective new vaccine will be made available to populations across the meningitis belt, starting in 2009 in Burkina Faso, which every year experiences huge epidemics. It will be phased into an additional 24 countries between 2010 and 2015.

Dr Eric Bertherat, from the WHO department of Epidemic Pandemic Alert and Response, came into the studio to talk about what causes meningitis and its impact on rural communities in Africa.

Dr Eric Bertherat: Meningitis is an infection of the meninges. Meninges are the thin linings which surround the brain and spinal cords. Meningitis can be caused by many things: it can be due to tumours or infections. The most important is meningitis due to bacteria. As a clinical presentation usually, that's fever, infection syndrome and stiff neck. This can be easily treated but it needs to be diagnosed early, to be treated appropriately and also it can be prevented by vaccine.

You can find bacterial meningitis worldwide. That's sporadic everywhere, but some regions are more affected than others, mainly developing countries, tropical countries. But there is a specific area in Africa which is called the meningitis belt, where there is a very huge incidence of this disease. And that's a real public health problem. It is a priority for these countries which are affected every year by huge outbreaks, and that's specific to this region of Africa.

You have a high incidence of meningitis all the year long, but during the dry season there is an increase of the disease. And, in addition to that, you can face huge outbreaks. It can be something around 20 000 to 30 000 cases for a country like Burkina Faso just in a six-month period. So that's a huge problem, and the problem is it kills a lot of people. Among the survivors there are many children, because it affects mainly the children. Lots of the children will stay with the neurological sequelae, but also it has a real impact on all the health systems in the countries because at the district level the dispensaries are overloaded with all these cases arriving at the same time.

Veronica Riemer: Marie-Pierre Preziosi, in the WHO Immunization, Vaccines and Biologicals Department, tells us about the new vaccine.

Marie-Pierre Preziosi: The vaccine we are going to use is called a conjugate vaccine and it has very interesting features as compared to the vaccine we are currently using. It will provide long protection, protect the community not only the individual and will protect young people as compared to the currently used vaccine.

The vaccine will be used in a wide range of population age 1 to 29 years. Because this population has experienced in the last century 80% to 90% of the burden of that disease in that part of the world.

The request really came from African countries themselves to the World Health Organization. They urged the WHO to support them with finding a solution and WHO partnered with PATH - Programme for Appropriate Technology in Health - which is an American NGO, and the Meningitis Vaccine Project partnership to develop this new vaccine. And in due time they found a developing country manufacturer that was willing to develop a vaccine at an affordable price. The next step was to find a laboratory, a group of scientists willing to develop the technology, and to transfer that technology to that manufacturer. And the third thing was to really implement things in the field. We can say today that that project has been so far extremely successful in that it has achieved the development of a product which has now been in clinical trials in three African countries and in India and has proven to be a safe and immunogenic conjugate vaccine. So it's almost ready to go for introduction in these countries.

This new product, the conjugate meningococcal A vaccine known as "MenAfriVac", was developed through the Meningitis Vaccine Project, a product development partnership set up in 2001 with core funding from the Bill & Melinda Gates Foundation.

Veronica Riemer: That's all for this episode of the WHO podcast. Thanks for listening.

If you have any comments on our podcast or have any suggestions for future health topics do drop us a line. Our email address is Podcast@who.int.

For the World Health Organization, this is Veronica Riemer in Geneva.

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