New meningitis vaccine in the pipeline
Dr Sanjit Bagchi
It is the most-feared disease in the Sub-Saharan African belt, which stretches from Gambia and Senegal on the Atlantic coast to Ethiopia and Somalia in East Africa - even though it kills fewer people than HIV, malaria or tuberculosis. To fight frequent epidemics of meningitis - which infects over 200,000 Africans every year either killing or maiming a third of those infected - public health experts have been looking for an ideal vaccine that confers long-term protection, that is suitable for all age groups and that breaks the transmission chain of the contagion in the population.
Above all, the vaccine has to be priced low enough so as to make it
affordable for poorer countries. That dream vaccine to tame the dreaded
infection is all set to turn into reality - thanks to a unique consortium
To create the new meningitis vaccine - custom-made for the African meningitis
belt - the Serum Institute of India has recently signed an agreement with the
international Meningitis Vaccine Project (MVP), run by
The joint venture will produce 25 millions doses of the vaccine every year at a cost as low as $ 0.40 cents per dose for the African meningitis belt.
"The agreement may offer a new paradigm for how vaccines or drugs are
made for the poor countries," said US Food and Drug Administration
scientist Carl E. Frasch in an email interview. "It's a concerted effort
Epidemics of meningitis have been occurring in the notorious 'meningitis belt' in Africa for more than a century. Such outbreaks surface roughly every eight to 12 years although their inter-epidemic period appears to be shrinking during the last two decades. The human toll of these epidemics can be enormous.
1998 and 2002, African countries within the meningitis belt reported more than
224,000 new cases of meningococcal meningitis to the World Health Organization
(WHO). However, cold statistics does not reflect the havoc actually associated
with meningitis epidemics. The disease strikes suddenly and unless antibiotics
are available and used quickly the death toll keeps rising. In addition,
long-term effects are noticed in
Over the last couple of decades public health measures have focused on an
approach based on early detection of the disease and mass vaccination of the
population at risk with polysaccharide vaccines. However, these
To address the limitations of the current public health strategy, expert
panels at the MVP devised the idea of a conjugate meningococcal vaccine.
"The Men A conjugate vaccine will help all people at risk from
Conjugate vaccines have excellent track record against meningococcal disease.
The first conjugate vaccine - a vaccine against meningitis caused by the
Haemophilus influenzae bacterium (Hib) - was licensed in 1987 and
Four years ago when WHO commissioned a panel of experts to assess the feasibility of the low-priced and high quality vaccine it was found that the shot was easier planned than actually produced. The intellectual property of the conjugation technology and production would come at such a hefty price that most countries in Africa won't be able to afford. No big pharmaceutical manufacturer was willing to make the shot at less than $ 1 per dose, and the target price was set at less than $0.50.
These seemingly insurmountable barriers forced the MVP to pursue a novel
approach. In the new model the proposal was to source the conjugation process
and basic components from a developed country, and then to
"In order to assure a low-priced, high quality vaccine we had chosen
this highly respected developing country manufacturer," said LaForce. The
Serum Institute of India, based near Bombay, has an excellent track
Jadhav, who is also president of the Developing Countries Vaccine
Manufacturers' Network believes this a path-breaking initiative in making cheap
vaccines for poor countries. "The success of Men A will indeed map
Dr Sanjit Bagchi is a medical practitioner and medical journalist, based in
India. Mr. Prasun Chaudhury, a senior science journalist from
Top photo: A mother sits by her sick daughter in a Ouagadougou clinic.
Bottom photo: Drought and dust storms are some of the factors associated with
the development of epidemics in the meningitis belt.
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