It is a deadly disease linked to high temperatures, airborne dust, and overcrowded living conditions – some of the very conditions that climate change threatens to exacerbate . It caused an estimated 250,000 deaths in 2019, ranks among the top killers of young children, and can leave survivors with brain damage and hearing loss.
This disease is bacterial meningococcal meningitis, and it can appear anywhere at any time. But it disproportionately affects the Meningitis Belt, which stretches across 26 countries in Africa and is home to hundreds of millions of people. Each year, this region experiences hot and dusty conditions that can enable meningitis to spread, and every 5-12 years, has devastating epidemics causing massive disease.
The good news? Meningitis can be defeated. In fact, the world managed to effectively eliminate the most common cause in the Meningitis Belt: meningitis A, where not a single case of that strain has been reported since 2017.
As we mark World Meningitis Day on October 5, we should work to build on this remarkable success by following a World Health Organization (WHO) road map that lays out what needs to be done to eliminate meningitis as a public health threat by 2030. But achieving this requires us to act together and decide to dedicate resources to preventing new cases and outbreaks, including deploying the most state-of-the-art vaccines, investing in diagnosis, treatment, and surveillance, and doing all we can to support people who survive meningitis. Doing so by 2030 would prevent nearly a million deaths and 800,000 people from living with the devastating consequences of infection.
First, prevention. Vaccines are available to prevent bacterial meningitis, and it was the widespread deployment of MenAfriVac®, a vaccine developed by the Meningitis Vaccine Project (MVP), a partnership between WHO, Serum Institute of India, and PATH, that helped effectively eliminate meningitis A in the Meningitis Belt.
Other strains of meningitis are rising, and may be moving into the ecological niche that meningitis A used to fill, but new tools are available. The MenFive® vaccine protects against a broader range of five strains including meningitis A. It has received WHO prequalification and has been recommended for use in the Meningitis Belt by the WHO Strategic Advisory Group of Experts (SAGE) on Immunization, which encouraged countries to switch to the newer vaccine.
Nigeria is leading the way with support from Gavi, the Vaccine Alliance, becoming the first country to launch a vaccination campaign with MenFive® in response to an epidemic and is now considering introducing it routinely to prevent cases and epidemics. More countries should follow suit and build on Nigeria’s leadership by integrating the vaccine into their routine immunization programmes to ensure long-term protection against meningitis. Effectively eliminating meningococcal meningitis, A involved vaccination efforts across 24 countries in the Meningitis Belt. A similarly comprehensive campaign to roll out a vaccine that provides broader coverage against growing strains is needed to help save more lives.
Prevention is an important step, but not the final one. Rapid diagnosis and treatment with antibiotics are key for a disease that can kill within 24 hours. Diagnostics are available but have their limitations, especially in the resource-limited environments found in many Meningitis Belt countries, where health workers may not have access to the necessary training or tools. More affordable, simpler, and rapid point of care tests are needed to help save as many lives as possible.
Beyond diagnosis, bacterial meningitis can be treated with antibiotics, but certain medicines may not always be available or appropriate depending on the nature of the infection. Updated treatment guidelines are needed, especially given the growing global threat of antimicrobial resistance.
In addition, improved surveillance is needed to address a persistent lack of information. Without detection, outbreak response efforts, including mass vaccination campaigns, may be delayed, and it is difficult to understand how different strains of the disease are evolving.
Finally, we must help care for survivors, one of every five of whom lives with severe issues like brain damage, and hearing and vision loss. Rehabilitative care can be prohibitively expensive or simply not available at all. Health workers need to be trained and equipped to help survivors navigate their lives.
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
There is much to be done to eliminate meningitis by 2030. But thankfully, we know it is possible. The effective elimination of meningitis A in the meningitis belt shows that it can be done, and the WHO road map points the way. The science and the know-how exist, but we still must dedicate the will and resources. Lives depend on it.
Seth Berkley, MD, is an Adjunct Professor at the Pandemic Center, Brown University School of Public Health and an advisor to numerous technology and vaccine companies including the Serum Institute of India. He served as CEO of Gavi, the Vaccine Alliance from 2011-2023.
Samba O. Sow, MD, MSc, FASTMH, is the Directeur Général CVD-Mali. He served as Minister of Health and Public Hygiene for Mali from 2017-2019.
