Julien Bonboungou

Julien Bonboungou looks forward to the day when his village is protected from meningitis. Photo: PATH/Gabe Bienczycki.

MenAfriVac® may one day mean the end of epidemic meningitis in Africa

On the first day the vaccine was available in his village, Julien Bonboungou closed his hairdressing shop in the mid-afternoon and walked toward the local health center. There, he waited his turn to be vaccinated against a disease that, with terrifying regularity, kills or disables thousands in sub-Saharan Africa, including Julien’s best friend from school, Hervé Compaore.

Hervé died at age 17 in 2006, one of 3,802 people killed when an epidemic wave of meningococcal meningitis A swept through portions of Africa, including the West African country of Burkina Faso. Since the epidemics began more than a century ago, people who live in the “meningitis belt”—from Senegal in the west to Ethiopia in the east—have had little protection against the disease. With devastating speed, it kills about one in ten people who get it and leaves one in four survivors permanently impaired by mental disorders or hearing loss.

In December 2010, health officials in Mali, Niger, and Burkina Faso introduced a new vaccine that protects people from the type of meningitis that causes almost all epidemics of the disease in Africa. Called MenAfriVac, the vaccine can be given safely to children as young as one year old. It should provide protection for ten years or more and blocks transmission of the disease to those who aren’t infected. And it does so at an affordable price—less than US$0.50 a dose.

For those reasons, health authorities believe, MenAfriVac has the potential to end epidemic meningitis in sub-Saharan Africa.

One day, an end to epidemics

“If all of this works the way we think it’s going to work,” says Dr. Marc LaForce, director of the Meningitis Vaccine Project (MVP), “we’re going to put an end to these epidemics. Full stop.”

“We're going to put an end to these epidemics. Full stop.”

MVP, a partnership between PATH and the World Health Organization (WHO), developed MenAfriVac. Because the vaccine blocks transmission of the meningococcal bacteria, it can create “herd immunity,” protecting even those who are not vaccinated—if a large enough percentage of the population is immunized.

If enough people receive the vaccine, WHO estimates, MenAfriVac will protect 450 million people from the disease, and it will save nearly 150,000 lives. And epidemic meningitis A could be a memory.

By the last days of 2010, nearly 20 million people had received MenAfriVac. By the end of 2011, the vaccine had been introduced in Cameroon, Chad, and Nigeria and had reached 54.5 million people. In the next few years, PATH and WHO plan to bring the vaccine to between 300 million and 315 million more children and young adults, ages 1 through 29, in the meningitis belt.

Both organizations are working to build support for sustaining the immunization effort. But even at less than $0.50 cents a dose, it will take an additional $475 million to protect people throughout the region. Funding has not yet been identified.

People standing outdoors, lined up to be vaccinated.

In Julien’s village, neighbors line up for MenAfriVac. Photo: PATH/Gabe Bienczycki.

To protect a village

The afternoon temperatures are rising in Julien’s village, but his neighbors continue to arrive and join the line for vaccine. The reason is simple, Julien explains. Everyone’s family has been touched by meningitis: an aunt deafened, a daughter who can no longer attend school, a little brother dead.

But for now, Julien greets his neighbors with a broad smile and a handshake. The gathering begins to feel less like a public health campaign and more like a celebration. Someone asks Julien: Is it worth it to be so hopeful? After all, what can one vaccine do?

He looks his questioner in the eye as he answers. “It’s going to protect my village,” he says.

MenAfriVac is a registered trademark of Serum Institute of India Ltd.