Meningitis A vaccine support

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Gavi-supported campaigns have reached over 220 million people

No new cases of meningitis A reported in vaccinated countries

Meningitis A Nigeria

School children holding immunisation cards in Nigeria, one of 15 countries that have launched meningitis A vaccine campaigns with support from Gavi. Credit: Gavi/2011/Ed Harris.


From 2010 to 2014, Gavi-supported meningitis A vaccine campaigns reached over 220 million children and young adults in 15 countries in the “meningitis belt”, which stretches across 26 countries in Africa. Those supported so far are Benin, Burkina Faso, Cameroon, Chad, Côte d’Ivoire, Ethiopia, Gambia, Ghana, Mali, Mauritania, Niger, Nigeria, Senegal, Gambia, and Togo.

On average, the campaigns have reached more than 85% of those at risk of contracting the deadly disease. The impact has been immediate: there were no new cases of meningitis A in vaccinated countries in 2014, and epidemics in the meningitis belt reached their lowest-ever recorded levels.

Burkina Faso and Chad, for example, have reported significant reductions in meningitis A rates across the population thanks to high vaccination coverage1. Following Chad’s campaign, the number of cases dropped by 94%.

A major setback was, however, the devastating Ebola outbreak, which meant some countries were unable to run vaccination campaigns in 2014. For example, Guinea was forced to postpone its meningitis A campaign until the situation improved.

The remaining 11 countries in the meningitis belt are expected to conduct campaigns in 2017/2018, vaccinating over 260 million people.

Controlled temperature chain increases reach of meningitis A vaccine

The MenAfriVac vaccine, developed to meet the specific needs of Africa’s meningitis belt, can be kept at temperatures of up to 40°C for no more than four days as part of a controlled temperature chain (CTC). This could help make campaigns more efficient, improve coverage and save funds otherwise spent on maintaining the challenging cold chain until the last mile.

Gavi funding has helped three countries – Côte d’Ivoire, Mauritania and Togo – use CTC to support their meningitis A vaccine campaigns. By removing the need for ice packs to keep vaccines between 2°C and 8°C, CTC has had a dramatic impact on the ease and efficiency of vaccine delivery. Most of the districts where the approach was used achieved very high coverage.

The CTC approach could have major economic benefits. According to a WHO study2, administering the MenAfriVac vaccine without having to keep it cold could reduce costs by 50%.

Learn more about CTC  

1 (Novak and al. The Lancet Infectious Disease, July 18 2012). (Kristiansen and al. Clinical Infectious Disease, Nov 19 2012).
2 Lydon et al, Bull of the WHO 2014.

Seasonal epidemics of meningitis A threaten 450 million people in Africa’s meningitis belt

Survivors can face brain damage, deafness and other disabilities


The disease is most prevalent in the sub-Saharan meningitis belt, a region of 26 sub-Saharan countries that stretches from Senegal and the Gambia in the West to Ethiopia in the East and has an at-risk population of about 450 million. Epidemics occur in the dry season, from December to June. An epidemic wave can last two to three years, dying out during the intervening rainy seasons.


Meningitis, an infection of the lining that covers the brain and spinal cord, has a variety of causes. The most frequent are either viral or bacterial, one of which is meningococcus. Five main meningococcal groups have been identified with group A being the most common, causing roughly 85% of meningococcal meningitis cases in the African meningitis belt.

However, Niger was recently hit by the first-ever large-scale meningitis C outbreak in the meningitis belt. Gavi contributed to the global response through its support to the meningitis emergency stockpile.

Those at highest risk of infection are infants, children, and young adults.

Read more about the meningitis belt 


The disease has a significant social and economic impact.

A study conducted in Burkina Faso in 2006/2007 found that households spent US$ 90 per meningitis case – equal to about 34% (or four months’ worth) of the average household income. When the disease caused disabilities, this increased to as much as US$ 154. In addition, many people are afraid either to socialise or to work during a meningitis epidemic for fear of catching the disease.

Gavi has collaborated with the Meningitis Vaccine Project to deliver an affordable vaccine against meningitis A in less than 10 years

Gavi support is available for preventive campaigns and routine immunisation


In an effort to eliminate deadly outbreaks, the Meningitis Vaccine Project, a partnership between the World Health Organization (WHO) and PATH, funded by the Bill & Melinda Gates Foundation, developed an affordable meningitis A vaccine.

History of MenAfriVac

In 2001, WHO and PATH, a non-profit body based in Seattle, USA, founded the Meningitis Vaccine Project with core funding from the Bill & Melinda Gates Foundation.

Its mission: to develop a vaccine at a price low enough – US$ 0.40 per dose – to enable widespread use in Africa. This would help ensure that epidemics such as the 1996–97 outbreak, which caused 250,000 cases and 25,000 deaths, would never happen again.

Commercial manufacturers in industrialised countries could not produce the vaccine at such a low target price. Therefore, the consortium carried out the research itself and contracted the Serum Institute of India in Pune to make the vaccine. The entire research and development cost of the project was 5 to 10 times less than for other typical vaccines.

In 2008, The Gavi Board approved support to immunise the entire target population in all 26 meningitis belt countries with MenAfriVac by 2016. With a high coverage rate among people aged below 30 years, representing approximately 315 million people, it is expected that epidemics will be eliminated from this region of Africa.

To ensure continued protection for future generations and following WHO prequalification of MenAfriVac in 2014, Gavi now also supports countries to introduce the vaccine into their routine immunisation schedules. 


In the 26 countries where meningitis A is endemic, Gavi currently supports:

Preventive campaigns

Gavi countries receive support for preventive campaigns on a one-dose vaccination schedule, as well as associated supplies. Countries receiving support for preventive campaigns do not receive a vaccine introduction grant. However, Gavi provides US$ 0.65 per individual in the target population of the campaign to help cover operational costs (expected to cover approximately 80% of the total estimated cost). Gavi’s aim is to facilitate timely and effective delivery of vaccines to the target population.

Introduction into the routine immunisation system

To prevent future outbreaks, meningitis A vaccine should be introduced into countries’ routine infant vaccination schedule within 1 to 5 years after their preventative vaccination campaign.1 

Gavi provides support for a one-dose meningitis A vaccination schedule, as well as associated injection supplies. Countries will receive a one-time cash vaccine introduction grant for the additional introduction costs. It is expected that the government and partners cover the remaining costs associated with the vaccine introduction.  

Mini catch-up campaigns

Gavi also supports simultaneous one-time “mini catch-up” campaigns. These target babies born between the preventive campaign and the introduction of the vaccine into the routine vaccination schedule.

Meningitis emergency stockpiles

Gavi contributes to a meningitis emergency stockpile to control outbreaks. The stockpile can include meningitis A as well as other serotypes, depending on the cause of the outbreak (Men AC; Men ACW/ACYW). This support covers emergency outbreaks in the 26 countries in the African meningitis belt.

The meningitis emergency stockpiles is coordinated through the international coordination group hosted by WHO.

Controlled temperature chain (CTC)

From 2014, additional Gavi support is available for countries wishing to use a controlled temperature chain strategy when implementing their meningitis A vaccine campaign. These funds are channelled through WHO.

1 WHO (2015) Meningococcal conjugate vaccine: Updated Guidance. Weekly Epidemiological Record (WER), 20 Feb, 2015, No. 8, 2015, 90, 57–68.
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