Defeating Meningitis in Africa

Chris Elias SEATTLE – Africa’s progress in fighting meningitis A is one of the best-kept secrets in global health. Thanks to the development and deployment of a low-cost vaccine, the lives of hundreds of thousands of children have been saved, and communities that might otherwise have been devastated by the illness are thriving. Meningococcal A meningitis is a bacterial infection of the thin lining surrounding the brain and spinal cord, and it can be deadly. For more than a century, epidemics have swept across 26 countries in Sub-Saharan Africa, killing and disabling tens of thousands of primarily young people every year. The disease is highly feared on the continent; it can kill within hours or leave its victims with severe brain damage. Outbreaks usually occur at the beginning of the calendar year, when dry winds from the Sahara Desert begin blowing southward. The 1996-1997 epidemic resulted in more than 250,000 cases and 25,000 deaths in Sub-Saharan Africa, many of them children. Of those who survived, one in four were left with permanent disabilities, including paralysis, blindness, hearing loss, seizures, and brain damage. The impact of meningitis A on families and communities is devastating. In order to pay for treatment, many families are forced to sell the assets they need to sustain their livelihoods: livestock, seed stock, and tools. Furthermore, the disabilities caused by the infection can leave survivors less able to earn income or care for themselves and their families. Whole communities can be plunged into deeper levels of poverty as health-care workers struggle to contain outbreaks. The suffering caused by the disease served as an impetus for action. Sixteen years ago, African health ministers, the international health NGO PATH, the World Health Organization (WHO), the Serum Institute of India, the Bill & Melinda Gates Foundation, and dozens of other partners formed the Meningitis Vaccine Project (MVP). The mission was simple: to develop an affordable vaccine to fight meningitis A in Africa. The project was successful. In less than ten years, the MenAfriVac vaccine was launched and has produced an immediate and dramatic break in the cycle of meningitis A epidemics. I was in Burkina Faso for the vaccine’s introduction in December 2010. I was worried whether anyone would show up. But when I met the minister of health the day before the launch and asked him what his biggest concern was, he gave me a surprising answer: “Crowd control.” He was right. Huge crowds formed at every immunization site, standing in line in the hot sun, eager to receive protection against the deadly disease. It was, quite literally, a state event, with the president in attendance. The first vaccination campaign reached virtually everyone in the country aged 1-29. In the five years since then, more than 235 million people have been immunized across Sub-Saharan Africa. By 2020, the vaccine is expected to protect more than 400 million people – preventing one million cases of meningitis A, 150,000 deaths from the disease, and 250,000 cases of severe disability among survivors. The MVP stands as a powerful example of what is possible when African leaders and experts from across the spectrum of global health work together. Strong, temporary partnerships, with a focused goal, can have truly catalytic effects. But the work is far from over. Last year, the WHO approved MenAfriVac for use in regular vaccine schedules, making it possible for millions more to be protected. The stakes are high. Universal access to immunization is a cornerstone of health, development, and economic growth. Recognizing this, several African countries are already making plans to roll out meningitis – and other – vaccines into routine immunization systems this year. The task before African leaders is to ensure a smooth and full transition from mass vaccination campaigns to routine immunization. Last week, government officials assembled in Ethiopia for the first-ever Ministerial Conference on Immunization in Africa, where they re-committed to ensuring that everyone on the continent has access to the vaccines they need. This will require further investment in immunization, improved data collection and analytics, new tools and approaches, and most importantly, strong partnerships. We must build on the legacy of the MVP and work toward a world in which every child receives the life-saving vaccines they need to survive and thrive. Chris Elias is of President of Global Development at the Bill & Melinda Gates Foundation. Copyright: Project Syndicate.

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Defeating Meningitis in Africa