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WHO prepares to tackle emerging crisis in African meningitis area

Negotiations with key manufacturers making progress

Strategies evolving to deal with newly epidemic strain

Stepped up surveillance vital to detect and respond to any new outbreak

The emergence of a newly epidemic strain of meningitis in West Africa earlier this year has given renewed urgency to the search for a more effective and affordable vaccine. Next week, the World Health Organization (WHO) and its partners will meet in Burkina Faso for urgent consultations to prepare for the likelihood of further outbreaks of the new strain in Africa, possibly as soon as next year.

Meningitis occurs periodically in epidemics that sweep through the "meningitis belt" of Africa in countries stretching from the West African coast to the Horn of Africa in the east. An existing vaccine is effective against the strains A and C of the bacteria which have thus far been responsible for most meningitis epidemics in the meningitis belt. However, it does not provide protection against a newly emerging epidemic strain known as W135.

An outbreak of W135 in Burkina Faso, which began in February and continued until May this year, infected more than 12 000 people and killed almost 1500. This was the first time W135 had been identified as the primary cause of a major epidemic of meningitis in Africa.

"This disease is a killer of African children," said Dr David Heymann, Executive Director of Communicable Diseases at WHO. "We have to find a way to get inexpensive, safe and effective vaccines to save young lives from this new strain."

The only currently available vaccine which does protect against W135 is a "tetravalent" meningitis vaccine, providing protection against four strains of meningitis, including A, C and W135. This vaccine is normally sold for at least US$ 5 a dose, compared to 25 cents a dose for the more widely used vaccine, which contains just strains A and C.

"This tetravelent meningitis vaccine is simply too expensive for countries in Africa, which are suffering the most from meningitis," said Dr Ebrahim M. Samba, Director of the WHO Regional Office for Africa. Since it has not been needed in large quantities until now, the manufacturers also have limited production capacity. So the vaccine is both unavailable and unaffordable.

Talks with key manufacturers on increasing production and on bringing down the price to an affordable level for African countries are progressing well. To prepare for likely outbreaks of meningitis in just a few months' time, between two million and five million doses of the tetravalent vaccine will be needed by WHO and its partners in the International Coordinating Group on vaccine provision for epidemic meningitis control (which includes UNICEF, Médecins sans Frontières and the International Federation of Red Cross and Red Crescent Societies).

Apart from the provision of an affordable vaccine, improved surveillance is also a vital component in WHO's strategy for identifying and responding to outbreaks quickly. A surveillance system already exists, which works effectively to identify and report cases of meningitis as people are being brought to health facilities for treatment. However, the system needs strengthening, as does the network of laboratories which perform the vital work of confirming cases of meningitis and identifying which strain has caused them.

In Burkina Faso next week, WHO and its partners will agree on the terms of a regional strategy for the meningitis belt in Africa. This will be accompanied by an international appeal for funding to purchase and provide vaccine for the next year and to strengthen the surveillance and laboratory networks which are vital to the control of this killer disease.

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For more information contact:

Mr Iain Simpson
Telephone: +41 22 791 3215
Mobile phone: +41 79 475 5534
E-mail: simpsoni@who.int

Please visit our health topic page on Meningitis for more information.