Interview with Muhammad Sani Adamu, Head of Accelerated Disease Control in Nigeria’s National Primary Health Care Development Agency, about rolling out the new vaccine against meningitis A
Schoolchildren in northern Nigeria wave their vaccination cards after immunisation against meningitis A in December 2011. Photo credit: MS Adamu/GAVI/2011
In December 2011, Chad, Cameroon, and Nigeria became the latest countries to introduce a new vaccine against meningitis A, MenAfriVac, expected to dramatically cut the region’s meningitis epidemics.
The vaccine is being introduced throughout the region with financial support from GAVI. Almost 55 million people in six countries have been immunised so far, according to figures from the Meningitis Vaccine Project.
In this interview with the GAVI website, Muhammad Sani Adamu, Head of Accelerated Disease Control in Nigeria’s National Primary Health Care Development Agency, answers questions about the roll-out of MenAfriVac in Nigeria’s northern states.
How important for Nigeria is the new vaccine against meningitis A?
Every year, we have thousands of meningitis cases though the intensity varies from year to year. People are always apprehensive, scared ahead of the meningitis season. They never know what will happen.
In 2009, we had nearly 50,000 cases and more than 2,000 dead.
Laboratory information indicates that serotype A is the most common strain of meningitis in Nigeria’s epidemics. So the new vaccine is a golden opportunity to protect our people against the commonest strain, responsible for 90% of all epidemics. MenAfriVac is a big deal actually for our country.
What was your role in the campaign?
As Chair of the National Planning Committee, I was responsible for national planning, including operations, logistics, training, finance, social mobilisation, monitoring and evaluation.
This work kept me very, very busy indeed! I had to make sure that everything is in place, to bring everybody together. The coordination of all this is not an easy task.
What do Nigerians think about the meningitis A vaccine?
The reaction among the people was excellent. They had something to allay their fears and concerns.
Because of the controversy that we had with polio (in 2003 when many people in northern Nigeria refused the polio vaccine), we started our communications and social mobilisation early. We used imams, teachers, and even motorcyclists with megaphones to mobilise the communities. We also kept the media fully engaged.
We also used music to flag off the campaign. A lot of music and fanfare. You need music to attract people to be there. State governors or their representatives hosted the musical and cultural fanfares at their palaces.
What were the biggest logistical challenges that you faced?
We were planning for about 8 months ahead of this 10 day campaign. The biggest challenges were the logistics and waste management issues. We did a cold chain assessment to see what is available, what are the shortfalls. We installed new cold rooms and used 30-tonne lorries to transport vaccines and injection materials from the national store to the states. In some places, we used motorcycles and bicycles to convey materials and personnel across the difficult terrain.
We also deployed 200 logistics officers and 25 media monitors to supervise and monitor the implementation of the campaign in the five states.
Nigeria was aiming to reach 17 million people in the two week campaign. How did it do?
Nigeria has 36 states plus a capital, but we targeted the 5 northern states which are worst affected by meningitis. The figure of 17 million is not an absolute figure, but a projection based on 2006 census data and projections of population growth. We had to do very careful planning and implementation.
Besides health facilities, we set up temporary vaccination posts in schools, markets, hard-to-reach settlements, even the palaces of the Emirs and other traditional leaders. Many of the traditional leaders went out themselves to make sure their people get vaccinated. Local town announcers with megaphones informed their communities of immunisation dates, indicating the dates and locations of the nearest vaccination posts.
In some cases, the campaign went beyond 10days because people were still coming (to be immunised).
From the preliminary data so far, we reached 15,654, 715 million people, representing about 93% of our target.
The "Meningitis belt"
Meningitis type A epidemics bring death, disability, and fear every year to the so-called “meningitis belt”, a string of countries that stretches from Senegal in the west to Ethiopia in the east.
The region’s biggest epidemic in recent years affected 250,000 people, killing 25,000 and leaving another 50,000 with disabilities from deafness to mental retardation.
Developed specifically for the “meningitis belt” by a consortium of partners collectively known as the Meningitis Vaccine Project, MenAfriVac costs less than 50 US cents per dose and is expected to save as many as 150,000 lives between 2010 and 2015.
Its initial results have been excellent, following December 2010 introductions in Burkina Faso, Mali, and Niger.
By the end of the 2011 epidemic season, Burkina Faso had had just four cases of meningitis A, all in unimmunised individuals, including three from Togo who came for medical care.