PATH: First Vaccine Developed Specifically for Africa Virtually Eliminated Meningitis across Majority of African Meningitis Belt

Product: MenAfriVac®

Product Type: Vaccine

Disease: Group A meningitis

Meningitis is a serious infection of the thin lining surrounding the brain and spinal cord. It has many causes, though bacterial cases are extremely serious and often fatal without treatment. In Africa, more than 80% of meningitis epidemics have historically been caused by Neisseria meningitidis group A bacteria,[i] a form of the disease that mostly attacks infants, children, and young adults. Without treatment, 50% of those infected can die within days. Those who survive the infection often suffer severe, lifelong disabilities such as deafness or paralysis.[ii]

Following the particularly devastating group A meningitis epidemic of 1996–1997 (which sickened more than 250,000 people and killed more than 25,000),[iii] African leaders called for a low-cost vaccine that would permanently end group A meningitis epidemics in Africa.

In 2001, PATH and WHO formed the Meningitis Vaccine Project (MVP) to develop a low-cost vaccine that would prevent group A meningitis outbreaks in Africa. No multinational vaccine manufacturer was willing to make a group A meningitis conjugate vaccine at a price African governments could afford; however, Serum Institute of India Private Ltd (SIIPL) agreed to produce the vaccine for less than US$0.50 per dose—the price set by African health ministers.

Together, PATH and partners created a new group A meningitis vaccine in record time, navigating rigorous regulatory and technical rules, organizing numerous clinical studies to test the safety and effectiveness of the vaccine, and building local capacity to conduct research and ultimately support product delivery. MenAfriVac® was the first vaccine to be developed for meningitis specifically for Africa. In addition to its relatively low cost, MenAfriVac® promotes herd immunity by reducing the bacteria carried in the nose and throat and interrupting the chain of transmission. MenAfriVac® also provides relatively long-term protection, which prevents group A meningitis epidemics before they start, and it can be delivered outside of the cold chain, providing access to even the most remote communities.

MenAfriVac® was prequalified by WHO in 2010. Its introduction in 2010 via mass vaccination campaigns has had an immediate and dramatic impact in breaking the cycle of group A meningitis epidemics. At the end of 2019, MenAfriVac® had been delivered to approximately 340 million people in 24 of 26 “meningitis belt” countries, virtually eliminating meningitis A wherever MenAfriVac® has been used.

“Meningitis is one of the most feared diseases in Sub-Saharan Africa. For decades, people lived epidemic to epidemic—until the Meningitis Vaccine Project developed and introduced MenAfriVac®, which changed the course of meningitis in Africa. The groundbreaking vaccine has prevented hundreds of thousands of cases of meningitis A and saved tens of thousands of lives. MenAfriVac® demonstrates the remarkable power of vaccines as public health tools, and what can be accomplished when a need becomes idea becomes action, a global need is met with global action.”

—NIKOLAJ GILBERT, PRESIDENT & CEO, PATH

Group A meningitis isn’t the only form of the disease that plagues Africa; groups C, W, X, and Y also circulate and can cause outbreaks and epidemics. With funding from the United Kingdom’s Foreign, Commonwealth, and Development Office (FCDO), PATH is once again partnering with SIIPL, this time to develop an affordable meningococcal conjugate vaccine against serogroups A, C, W, X, and Y. The vaccine candidate is undergoing Phase III clinical study in Mali and The Gambia—a crucial step on the pathway to licensure, and to potentially eliminating all forms of epidemic meningitis in the meningitis belt.

i. World Health Organization. Control of epidemic meningococcal disease. WHO practical guidelines. 2nd edition. World Health Organization. 1998. https://www.who.int/csr/resources/publications/meningitis/whoemcbac983.pdf.

ii Meningococcal meningitis: Key Facts. World Health Organization. https://www.who.int/news-room/factsheets/detail/meningococcal-meningitis. Accessed October 2020.

iii. Teresa Aguado, M, Luis Jodar, M, Granoff, D. et al. From Epidemic Meningitis Vaccines for Africa to the Meningitis Vaccine Project, Clinical Infectious Diseases, Volume 61, Issue suppl_5, November 2015, Pages S391–S395.