Navrongo Health Research Centre
(Navrongo)
Dr. Abraham Hodgson
30 March 2007
SPONSOR WIRE
Navrongo, Ghana — Right now Africa may be gearing up for a recurring health crisis: a major outbreak of meningococcal meningitis. About every 8-12 years, massive epidemics sweep across the "Meningitis Belt," which stretches from Senegal to Ethiopia. With new vaccines on the horizon, modern medicine may soon provide better tools to fight this scourge.
Meningococcal meningitis is a bacterial infection that strikes with lightning speed. If left untreated, meningitis can kill up to half of those infected within 48 hours. Survivors can suffer permanent disabilities such as mental retardation, deafness, or paralysis.
Eleven years ago, during one of the largest epidemics on record, meningitis affected more than 250,000 and killed more than 25,000 people. In addition, outbreaks occur every year in the meningitis belt during the dry season. Last year, for example, the World Health Organisation reported more than 31,677 cases and 2,783 deaths in the meningitis belt.
Meningitis is more than just a seasonal problem. In Africa, it targets our youngest year-round. Children under 5 years of age represent more than half of all the meningitis cases that occur outside epidemics.
A recent spike in infections suggests the beginning of another large-scale epidemic. We are not defenseless. Using meningitis vaccines developed in the 1960s in a re-active immunisation campaign would save thousands of lives. This strategy, however, is not ideal. Emergency immunisations are expensive. -- just last year, Burkina Faso spent approximately US$3.5 million on a reactive vaccination campaign, one considered moderate in scale. Also the current vaccines do not protect babies. Even in adults, immunity wears off after a few years, leaving people vulnerable to the next epidemic.
Africa needs a new strategy to defeat meningitis. Experts agree the best long-term solution is an improved vaccine that could be given to babies and protect them for life. In 2000, the WHO formally called for a new vaccine that could be incorporated in routine child vaccination programmes. Routine immunisation would allow our public health officials to shift from crisis mode to sustainable, long-term prevention strategies.
Scientists have risen to the challenge. They have developed a new class of vaccines that would protect our most vulnerable, our children. Modern vaccines are being tested around the world and they could be available here soon. One particularly promising candidate was submitted for approval to the European Medicines Agency this week and could be available as early as next year. Alongside expanded treatment and ongoing vaccination for older children and adults, this new tool will help break the meningitis epidemic cycle and put an end to costly last-minute vaccination campaigns.
In addition to being the most advanced in its development, this particular candidate is also remarkable for being a combination vaccine. It would take public health in the meningitis belt to a new level by simultaneously protecting against other major diseases of great importance in Africa, like hepatitis B, tetanus, pertussis, diphtheria, and another form of meningitis, caused by the bacteria Haemophilus influenzae. Designed expressly for this region, this vaccine would simply replace the current combination vaccine.
Clearly, we have to protect our children from more than one disease. It's similar to patching holes in a bucket – all holes should be patched at once instead of patching some and leaving others.
Every Immunisation Day, mothers proudly line up at health clinics with their smiling babies. Even the mothers who leave with crying babies are glad they came, because they know that one jab is worth the priceless gift of health. In a few years, we could ensure that this one jab also includes meningitis, giving children fuller protection.
There is no excuse for a delay. It is up to us to show that Africa can implement smart, long-term solutions based on innovative technology. It is up to us to build the necessary political will in the WHO and purchasing organisations, such as the Global Alliance for Vaccines and Immunisation. It is up to us to convince international bodies and our governments to budget for these new vaccines that can end this cycle once and for all. And it is up to us to gain the support of those who can deliver the vaccines on the ground, such as medical practitioners and Ministries of Health.
We do not know when the next meningitis epidemic will hit. But, as we do our utmost to prepare for it, let us remember that there is another option over the long term. Next time, we do not just have to witness the devastation or lose friends and family to this disease.
Let us instead honour them by changing course and raising our voices, since they can not. Let us start to make good on a new promise, a new tradition now emerging in Africa.
* Dr Hodgson is the Director of the Navrongo Health Research Centre, a part of Ghana's Ministry of Health.
Copyright © 2007 Navrongo Health Research Centre. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com).
