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Defeating meningitis through vaccination

February 3, 2020 by Dr. Mark Alderson

PATH is part of a global task force working to eliminate meningitis as a public health threat by 2030

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More than 10 million people were vaccinated against meningitis A in just 10 days during the 2010 launch of MenAfriVac® in Burkina Faso. Photo: PATH/Gabe Bienczycki

This article originally appeared on the Meningitis Research Foundation's website.

PATH is on a mission. We want to see a world without meningitis. It’ll be a long, complex process, and it can’t be done without strategic, coordinated partnership and a multi-pronged approach, but we know it’s possible.

And with a concerted effort, we think it’s possible to have enormous impact by 2030.

An estimated 2.82 million cases of bacterial meningitis occur globally each year, with more than 300,000 deaths—a third of which are in children between one month and five years of age. And people living in low- and middle-income countries where existing interventions are impractical or cost prohibitive are at an even higher risk. This disparity is particularly evident in the African meningitis belt, which spans 26 countries from Senegal in the west to Ethiopia in the east and has a population of over 400 million.

Since 2001 PATH has been working to eliminate meningococcal meningitis from sub-Saharan Africa, and we’ve seen huge successes along the way. The 2010 introduction of MenAfriVac® —an affordable, vaccine against meningitis A, and designed specifically for the African meningitis belt—changed the face of meningitis epidemics in Africa. More than 315 million people have since been immunized across 24 countries and meningitis A has virtually disappeared wherever the vaccine has been introduced.

It’s a huge, historical achievement that has saved tens of thousands of lives—but it’s not enough. We want to go further.

That’s why we’re committed to defeating meningitis by 2030. Along with the Meningitis Research Foundation, the World Health Organization (WHO), and partners around the world, PATH is strategizing ways to eliminate meningitis as a global health threat and identify priority areas in which to focus our efforts.

Vaccines are an essential part of that. Meningitis is severe and it progresses quickly—making antibiotics and other treatments relatively ineffective. We can’t just treat. We need to prevent.

Which is why we’re on the front lines, working with vaccine development partners on novel prevention strategies for the three major causes of meningitis – Neisseria meningitidis (meningococcus), Streptococcus pneumoniae (pneumococcus), and group B Streptococcus (GBS).

Neisseria meningitidis

MenAfriVac® has been undeniably successful at eliminating meningitis A outbreaks in Africa, but meningitis A isn’t the only form of the disease that poses a threat; groups C, W, X, and Y also circulate and cause outbreaks and epidemics.

PATH and partners are working to extend the legacy of MenAfriVac® by developing an affordable meningococcal conjugate vaccine against serogroups A, C, W, X, and Y. That vaccine is undergoing late-stage clinical study in Mali and The Gambia and is on track to achieve licensure and WHO prequalification in the near future. This vaccine has the potential to eliminate all meningococcal meningitis outbreaks in sub-Saharan Africa.

Vaccines save countless lives by allowing us to prevent disease rather than just treat it.

Group B Streptococcus

The leading cause of sepsis and meningitis in young infants, GBS causes more infant deaths than HIV, and more than tetanus, pertussis, and respiratory syncytial virus combined. It also causes problems during pregnancy: GBS has been tied to pre-term birth, miscarriage, and stillbirth. No vaccines exist for GBS, however.

Because GBS causes disease in infants too young to immunize, we’re working with partners to develop a vaccine that can be delivered to pregnant women, who will then pass along protective antibodies to their babies—a strategy referred to as maternal immunization. The GBS vaccine is in early-stage development but we look forward to the day this powerful intervention is part of our meningitis prevention toolkit.

Streptococcus pneumoniae

Pneumococcal disease kills nearly 400,000 children before their fifth birthday every year—mostly in low-resource countries in Africa and Asia. In addition to pneumonia, pneumococcus is a leading cause of sepsis and meningitis.

Effective pneumococcal conjugate vaccines (PCVs) already exist and save lives around the world, but their high costs mean that many countries can’t afford them without substantial donor assistance. Or sometimes even at all.

That’s why PATH supported development of a new PCV that would be more affordable—but just as effective as existing vaccines—for the countries that need it most. That vaccine just achieved WHO prequalification, which means it is now available to low income countries around the world and can help us overcome one of the most persistent roadblocks plaguing pneumococcal disease prevention—cost.

Though vaccines are only part of puzzle when it comes to defeating meningitis by 2030, they are an essential part—and one that PATH is committed to advancing. Vaccines save countless lives by allowing us to prevent disease rather than just treat it. And with a disease as virulent and multifaceted as meningitis—prevention is key.

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