Eliminating epidemic meningitis in sub-Saharan Africa
The Meningitis Vaccine Project (MVP) is a partnership between PATH and the World Health Organization.
The mission of the MVP is to eliminate meningitis as a public health problem in sub-Saharan Africa through the development, testing, introduction, and widespread use of conjugate meningococcal vaccines.
Our objectives are:
‘Once such an initiative is accepted by all the countries, and a commitment is made, epidemic meningitis will be a thing of the past.’
Prof. Francis Nkrumah, Chair of MVP's Project Advisory Group
To develop meningococcal conjugate vaccines that are appropriate for use in Africa.
To monitor the effectiveness and safety of the vaccines in controlled clinical trials.
To create pathways for the licensure of vaccines.
To assure production in sufficient volume at a price that facilitates wide use in Africa.
To investigate innovative ways to finance the procurement of vaccines through local, country, and other global programs.
To introduce the vaccines through mass and routine immunization in synergy with other public health programs.
About meningitis
Neisseria meningitidis is a leading cause of bacterial meningitis. |
A much-feared disease
Meningitis is an infection of the meninges, the thin lining that surrounds the brain and spinal cord. It is sometimes referred to as spinal meningitis.
The most common causes of meningitis are viral and bacterial; fungal and parasitic infections are much less frequent. Knowing whether meningitis is caused by a virus or bacterium is important because the severity of the disease and its treatment depend on the type of infection:
- Viral meningitis is generally benign and resolves without specific treatment.
- Bacterial meningitis is much more serious because its onset is rapid and the infection is associated with a significant risk of death. Bacterial meningitis may also result in mental retardation, deafness, epilepsy, or necrosis leading to limb amputation. It is important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people.
Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis, but new vaccines given to all children as part of their routine immunizations have reduced the occurrence of invasive disease due to H. influenzae. Today, Streptococcus pneumoniae and Neisseria meningitidis (meningococcus) are the leading causes of bacterial meningitis.
R&D strategy
MVP team.
MVP team, friends, and partners at the International Pathogenic Neisseria Conference, Rotterdam, September 2008.
Partnering with the best
At MVP we avail ourselves of scientific, technical, and business expertise from around the world to achieve our mission and objectives. We draw from the best academic, industrial, and independent resources available in the fields of immunology, epidemiology, vaccine research and development, and project management. We use the most promising technology, create innovative partnerships, and collaborate closely with public health officials and other stakeholders in Africa to ensure that the new vaccines meet the expectations and needs of African nations.
accine introduction strategy
Two-pronged approach includes mass vaccination and integration into existing programs
Introducing the newly developed vaccine, making sure all at-risk children are protected, is our next big challenge. |
Our introduction strategy is two-pronged: mass-vaccinate to gain immediate benefits on a public health level and then integrate the vaccine into routine childhood vaccination programs.
Mass immunization campaigns
Comprehensive mass immunization campaigns of 1- to 29-year olds with a single dose of MenAfriVac are a cornerstone of the meningococcal A conjugate vaccine introduction plan. This strategy aims to strongly and immediately reduce bacterial carriage and transmission and thereby rapidly reduce disease-related morbidity and mortality rates. Because large population groups will be immunized in a short period of time, the public health benefits of immunization should be rapidly visible and considerable. If these mass campaigns are not conducted, the populations will not be protected against epidemics.
Protection of birth cohorts
After mass vaccination campaigns have been conducted among 1- to 29-year olds, the main challenge will be protecting birth cohorts throughout infancy. The strategy used will depend on the results obtained in the infant study currently taking place in Ghana and on Expanded Programme on Immunization (EPI) coverage rates in the involved countries.
- In countries where EPI coverage is high (>80% DTP3), MenAfriVac could be integrated into the existing EPI calendar. Two schedules are being evaluated: a single dose during the second year of life or two doses at 14 weeks and 9 or 12 months of age (concomitantly with measles or yellow fever).
- In countries where EPI coverage is low (<60% DTP3), follow-up single-dose campaigns targeting children aged 1 to 4 years could be organized every 5 years.
The plan is consistent with the WHO Global Immunization Strategy and Vision and will use the comprehensive multiyear planning process—a 3- to 5-year plan that outlines a country's immunization priorities, how they plan to integrate immunization activities, what the costs will be, what new vaccines they are planning to introduce, and how they will expand coverage. This work will require advocacy and a major public health commitment on the part of meningitis belt countries and donor agencies.
The introduction of the new vaccine is a giant step toward achieving elimination of epidemic meningitis as a public health problem in sub-Saharan Africa.