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New meningitis A vaccine is a "breakthrough" for 430 million people at risk

¹ London

The approval by the World Health Organization of a low cost vaccine against meningitis has been hailed by the charity Médecins Sans Frontières as a move "full of promise" for the 430 million people at risk of the disease in the meningitis belt of sub-Saharan Africa.

Cathy Hewison, the charity’s medical adviser, told the BMJ that the new vaccine, called MenAfriVac, could virtually eliminate the epidemic form of the disease but warned that the full rollout of this "much needed vaccine" depends on sufficient funds being mobilised. Médecins Sans Frontières has been leading the Campaign for Access to Essential Medicines.

Dr Hewison said the existing vaccine "confers very short term protection, limiting the effectiveness of our current response to outbreaks." As the new vaccine gives four times greater protection and lasts 10 years, "it’s a game changer to prevent epidemics in the future."

Dr Hewison said the new drug "works better than existing polysaccharide vaccine, lasts longer and a major benefit is that it can help stop transmission because it eliminates the healthy carrier state and can confer herd immunity, which wasn’t possible with previous vaccines."

She said, "Previously we had to first identify outbreaks and then send the vaccines from the limited stocks available in Europe. Now we can plan campaigns and prevent the outbreaks caused by the meningococcus bacterium," which causes the epidemic form of the disease that affects the meningitis belt.

She said that the meningitis belt consists of over 20 countries across north and central Africa, where epidemics often occur during the annual dry season, when hot, dry winds are thought to irritate the nasal passages and aid the bacteria’s transmission.

She said that the new vaccine is initially being rolled out in three of the highest burden countries: Niger, Burkina Faso, and Mali. Mass vaccination campaigns will start this autumn with support from GAVI (Global Alliance for Vaccines and Immunization) and WHO.

The campaigns will initially target everyone between one and 29 years old, after which each year’s cohort of one year olds will be targeted.

Dr Hewison said that, aside from the medical importance of the new vaccine, the development of this new product is "proof that innovative models for vaccine development can deliver." WHO, in collaboration with the non-profit health organisation PATH (Program for Appropriate Technology in Health), have "put medical needs and final product affordability at the forefront of the development process."

An Indian manufacturer, the Serum Institute of India, acted as the development partner and will manufacture the vaccine at an agreed starting price of $0.40 (£0.27; Euro 0.33) per dose.

WHO estimates it will cost $475m to supply the vaccine in the 22 countries with the highest need.

Tido von Schoen-Angerer, director of the Campaign for Access to Essential Medicines, said, "This is a complete revolution compared to the usual patent based, profit driven. Its developers have succeeded in tailoring the product to suit developing country medical needs, and keeping the vaccine affordable."

Dr von Schoen-Angerer said this was "a striking contrast to the blockbuster vaccines developed by the largest commercial developers for Western markets that fetch extremely high prices and aren’t produced with developing country needs in mind."

Cite this as: BMJ 2010;341:c3552