How a partnership stopped meningitis

January 8, 2015 by PATH

What's it take to get a vaccine approved for infants in Africa?

Making an immunization essential for infants is the best option for long-term control, especially after it becomes part of a country’s routine health care. Photo: PATH/Gabe Bienczycki.

Making an immunization essential for infants is the best option for long-term control, especially after it becomes part of a country’s routine health care. Photo: PATH/Gabe Bienczycki.

Imagine a group project where your partners are scattered across the world, millions of lives are at stake, and the goal is seemingly unachievable. That was the Meningitis Vaccine Project (MVP).

MVP existed from 2001 to 2015 as a collaboration between the World Health Organization (WHO) and PATH, in partnership with the Serum Institute of India Ltd. (SIIPL) and public health officials across African countries.

MVP had one goal in mind: to eliminate epidemic meningitis in sub-Saharan Africa.

For years, people living in the meningitis belt, a region that stretches from Senegal in the west to Ethiopia in the east, were regularly struck by meningitis A epidemics in which a sudden onset of disease could rapidly lead to death or permanent disability.

The epidemics would come in waves, affecting up to hundreds of thousands of people, with high mortality rates. The only existing meningitis A vaccines available for use in Africa were ineffective in breaking these cycles, and expensive and difficult to deliver in hard-to-reach areas of sub-Saharan Africa.

Africa needed a new vaccine; MVP delivered MenAfriVac®, a conjugate vaccine against meningitis A designed specifically for the economic and environmental realities of Africa.

It was a daunting assignment, but one successfully achieved through innovative, effective collaboration.

MVP was unique and pioneering from the onset

Step one involved listening to the affected countries. Health ministers wanted a practical, affordable vaccine to alleviate the suffering of their people.

Step two focused on developing the tactics and strategy to achieve the goal. The latter wasn’t easy, and as one door closed, the MVP team made sure to open others, even when they were stuck, barred shut, or seemingly too small. If there was no door, then the team looked for a window.

Motorcycle with a box labeled BD

The MenAfriVac vaccine can survive hot, long-distance travel to remote towns and villages. Photo: PATH/Gabe Bienczycki.

“The team made sure to open doors, even when they were stuck, barred shut, or seemingly too small. If there was no door, then the team looked for a window.”

The keys to success

It can take years, and often decades, for a vaccine to reach the public. This timeline is even longer in low-resource countries. Teamwork was critical to success.

MVP worked with an unprecedented number of global partners, including SIIPL (the vaccine manufacturer), and Gavi, the Vaccine Alliance. Our partners were visionary and had the end in mind at the beginning. Despite political instability and outbreaks of other diseases in the region, the team forged ahead.

Close up of a child looking over a woman's shoulder as he is carried at the MenAfriVac launch.

Close up of a child at the MenAfriVac vaccination launch in Burkina Faso. Photo: PATH/Gabe Bienczycki.

Remarkably, the first large-scale vaccination campaigns began in 2010, the same year that MenAfriVac was licensed and WHO prequalified for people aged 1–29 years. To date, not a single case of meningitis A has been reported among the more than 215 million people who have been vaccinated.

With the wonderful news of the infant vaccine approval and availability, this protection can now be extended to all babies in the region with the other essential vaccines that are routinely delivered to keep them healthy.

Remarkably, the first large-scale vaccination campaigns began in 2010[NL1] , the same year that MenAfriVac® was licensed and WHO prequalified for people aged 1–29 years. To date, more than 284 million people have been vaccinated with MenAfriVac® and meningitis A has virtually disappeared wherever the vaccine has been used.

Why this was all possible

Another key reason for our success is that our country partners were involved from the start. We worked directly with countries to focus on the end goal; ensuring a vaccine price, supply, and implementation plan that focused on sustainability.

This sets us up for the next challenge. MVP didn’t stop problem solving when outbreaks were over. They knew meningitis was still out there. Yet to succeed, the team kept moving ahead and working hard even when a meningitis outbreak wasn’t in the news.

Even though MVP has since closed, the success of this program continues because of our goal of putting country involvement and country ownership front and center from the very beginning.

Table with MenAfriVac vaccine in an insulated box and a disposal box for syringes.

A health worker prepares her table during the launch of MenAfriVac in Burkina Faso. Photo: PATH/Gabe Bienczycki.

PATH’s role in the future

The greatest sign of success for us is to have programs at PATH wrap up, and then watch them continue on after empowering countries and partners to own them.

When MVP achieved its last milestone—prequalification of the infant MenAfriVac—PATH, WHO, Gavi, SIIL, and other partners continued to work diligently to assist countries in ensuring the project’s successes would live on. As a result, the vaccine has been delivered in catch-up vaccination campaigns to millions of babies across the meningitis belt, and has so far been introduced in seven countries as part of the routine childhood immunization suite. And, we’ve begun developing ways to eliminate epidemic meningitis from Africa once and for all.

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

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