Meningitis A vaccine support

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Gavi-supported campaigns have reached over 235 million people

No new cases of meningitis A reported in vaccinated countries

Meningitis A Nigeria

School children holding immunisation cards in Nigeria. It is one of 16 countries that have launched meningitis A campaigns with support from Gavi.
Credit: Gavi/2011/Ed Harris.

EPIDEMICS REACH LOWEST-EVER RECORDED LEVELS

Gavi-supported meningitis A vaccine campaigns have reached 235 million children and young adults in 16 countries. They are part of the “meningitis belt”, which stretches across 26 countries in Africa. Those supported so far are: Benin, Burkina Faso, Cameroon, Chad, Côte d’Ivoire, Ethiopia, the Gambia, Ghana, Guinea, Mali, Mauritania, the Niger, Nigeria, Senegal, the Sudan, and Togo.

On average, the campaigns have reached more than 85% of those at risk of contracting the disease. The impact has been dramatic. The number of recorded epidemics in the meningitis belt have dropped to their lowest-ever level.

After 1.8 million people received one dose of the vaccine in three regions of Chad, meningitis rates fell by 94%. Also, there were no new cases in children aged less than 1 year or in adults older than 29 years. This shows the positive impact even among those not vaccinated.

In 2016, Gavi started supporting routine vaccination of children aged 9–18 months. By September 2016, six countries had been approved for this type of support. Gavi also funds catch-up campaigns. These help to cover children who are born after a mass campaign has taken place.

Controlled temperature chain increases reach of meningitis A vaccine

The MenAfriVac vaccine was developed to meet the specific needs of the meningitis belt. It can be kept at temperatures of up to 40°C for a maximum of four days as part of a controlled temperature chain (CTC). This can help improve coverage and save money otherwise spent on maintaining the challenging cold chain until the last mile.

Our funding has so far helped three countries – Côte d’Ivoire, Mauritania and Togo – use CTC in their meningitis A 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 that used this approach achieved very high coverage.

The CTC approach could have major economic benefits. According to a WHO study1, administering the MenAfriVac vaccine without having to keep it cold could reduce costs by 50%.


1 Lydon et al, Bull of the WHO 2014.

Seasonal epidemics of meningitis A threaten 450 million people in Africa

Survivors can face brain damage, deafness and other disabilities

MENINGITIS BELT

Meningococcus

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.

There are five main meningococcal groups. Group A is the most common, causing roughly 85% of meningococcal meningitis cases in the meningitis belt.

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

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

Read more about meningococcal meningitis  

Meningitis A is most prevalent in the sub-Saharan “meningitis belt”. This area stretches from Senegal in the West to Ethiopia in the East, with 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.

SOCIAL AND ECONOMIC IMPACT

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. This is 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. Also, many people are afraid to socialise or work during an epidemic for fear of catching the disease.

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

Support is available for preventive campaigns and routine immunisation

MENINGITIS VACCINE PROJECT

The Meningitis Vaccine Project is a partnership between WHO and PATH. It was set up in 2001 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 was to ensure that epidemics such as the 1996–97 outbreak, which caused 25,000 deaths, would never happen again.

Manufacturers in industrialised countries could not produce the vaccine at such a low price. Instead, the consortium carried out the research itself. It then contracted the Serum Institute of India in Pune to make the vaccine.

The vaccine was developed in record time, at less than one tenth of the cost of a typical new vaccine.

In 2008, the Gavi Board approved support to immunise all meningitis belt countries by 2016. With high vaccination coverage among people below 30 years of age, epidemics could be eliminated from the meningitis belt.

Gavi now also supports countries to introduce the vaccine into their routine systems. This will ensure that future generations are protected.

GAVI FUNDING SUPPORT

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

Preventive campaigns

Countries receive support for preventive campaigns on a one-dose vaccination schedule. They also get support for injection supplies. Countries receiving support for preventive campaigns do not receive a vaccine introduction grant. Gavi provides US$ 0.65 per individual in the target population to help cover operational costs.  

Introduction into the routine immunisation system

The vaccine should be introduced into the routine schedule within 1-5 years after the preventive campaign.1 This will help to prevent future outbreaks.

Gavi provides support for a one-dose meningitis A vaccination schedule and injection supplies. Countries receive a one-time vaccine introduction grant for additional introduction costs. 

Mini catch-up campaigns

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

Meningitis emergency stockpile

Gavi contributes to an emergency stockpile to control outbreaks in the meningitis belt. The stockpile can include meningitis A as well as other serotypes, depending on the cause of the outbreak (men AC; men ACW/ACYW). 

The International Coordinating Group, hosted by WHO, coordinates the meningitis emergency stockpile.

Controlled temperature chain (CTC)

Countries can get support to use a controlled temperature chain strategy in their meningitis A campaigns. WHO channels this funding.


1 WHO (2015) Meningococcal conjugate vaccine: Updated Guidance. Weekly Epidemiological Record (WER), 20 Feb, 2015, No. 8, 2015, 90, 57–68. http://www.who.int/wer/2015/wer9008.pdf?ua=1
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