Urgent call for action on meningitis in Africa
Vaccine price and shortage the major obstacles
OUAGADOUGOU, Burkina Faso , 27 September 2002 - A readily available supply of affordable vaccine is vital for the success of a new action plan to tackle the emergence of a newly epidemic strain of meningitis in Africa. That is the key conclusion of an urgent consultation held in this West African capital this week.
Experts from across the world, and most importantly from across Africa, gathered in Burkina Faso, the first African country to experience an epidemic of a new strain of meningitis known as W135. The outbreak, which began in February this year, infected more than 12 000 and killed almost 1500 people.
"To prepare for the next epidemic season, we must build strong ties between African countries who need access to existing but unaffordable vaccines and antibiotics and the private and public sectors in rich countries who hold the keys to these products," said Dr Jean Gabriel Ouango, Secretary General of the Ministry of Health in Burkina Faso, who chaired the meeting.
The experts agreed that the most important tool required is a vaccine that can be used to tackle all future outbreaks of meningitis in Africa. Such a vaccine would have to cover three different strains of the bacteria which have caused outbreaks in the past - including the new W135 strain - and which could cause new epidemics as early as the end of 2002.
A vaccine which contains all three strains exists and is used routinely in developed countries, but the current market price (which ranges from US$ 4 to US$ 50 a dose) is far beyond what African countries can afford to pay. The experts agreed that a price of more than US$ 1 per dose for this "tetravalent" vaccine would severely hamper its use in epidemic situations in Africa and that every effort should be made to lower the price while boosting production. Negotiations are already under way to bring down the price of the vaccine.
"Countries in Africa have no choice but to respond to epidemics of meningitis. We must help them to protect their children against a disease that cripples and kills," said Dr Daniel Tarantola, WHO Director of Vaccines and Biologicals.
Other vital measures to be taken in preparation for the next potential outbreak of W135 include improved disease surveillance in health clinics and hospitals, a better linked network of district laboratories that would serve as an early warning system, the urgent testing of new medicines to treat those who become infected, and an enhanced capacity to get the vaccines quickly to where they are needed.
Currently, meningitis patients in Africa are treated using oily chloramphenicol, an antibiotic which is little used in industrialized countries and, therefore, produced in insufficient quantities worldwide. However, a treatment using a single dose of the drug ceftriaxone has shown early promise. Ceftriaxone may be easier to obtain and use and is possibly more effective. More research is required to test this drug before it can be widely adopted as an alternative to the existing treatment.
The final ingredient required to tackle future outbreaks is the financial and political commitment of affected countries and their neighbours, as well as the international donor community, to pool resources and work together to protect people and save lives. This commitment was clearly and impressively present during the two days of expert consultation. Those present pledged to continue working to solve this urgent problem.
Intensive talks between the World Health Organization (WHO) and its partners in meningitis preparedness and response have produced a plan for medical, political and financial action. Immediate action is urgently required to prepare for another outbreak of a newly emerging strain of meningitis known as W135, which could begin within the next few months.
* Meningitis is a bacterial disease which affects the brain membrane. It can cause severe brain damage and is fatal in 50% of cases if untreated. It occurs periodically in epidemics across the "African meningitis belt," which stretches from the West African coast to the Horn of Africa in the east and elsewhere.