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From Epidemic Meningitis Vaccines for Africa to the Meningitis Vaccine Project
M Teresa Aguado1, Luis Jodar2, Dan Granoff3
1Vaccines and Immunization Consultant, Versoix, Switzerland.
Background:
Polysaccharide vaccines had been used to control African meningitis epidemics for >30 years but with little or modest success, largely because of logistical problems in the implementation of reactive vaccination campaigns that are begun after epidemics are under way. After the major group A meningococcal meningitis epidemics in 1996-1997 (250,000 cases and 25,000 deaths), African ministers of health declared the prevention of meningitis a high priority and asked the World Health Organization (WHO) for help in developing better immunization strategies to eliminate meningitis epidemics in Africa.
Methods:
WHO accepted the challenge and created a project called Epidemic Meningitis Vaccines for Africa (EVA) that served as an organizational framework for external consultants, PATH, the US Centers for Disease Control and Prevention (CDC), and the Bill & Melinda Gates Foundation (BMGF). Consultations were initiated with major vaccine manufacturers. EVA commissioned a costing study/business plan for the development of new group A or A/C conjugate vaccines and explored the feasibility of developing these products as a public-private partnership. Representatives from African countries were consulted. They confirmed that the development of conjugate vaccines was a priority and provided information on preferred product characteristics. In parallel, a strategy for successful introduction was also anticipated and discussed.
Results:
The expert consultations recommended that a group A meningococcal conjugate vaccine be developed and introduced into the African meningitis belt. The results of the costing study indicated that the "cost of goods" to develop a group A - containing conjugate vaccine in the United States would be in the range of US$0.35-$1.35 per dose, depending on composition (A vs A/C), number of doses/vials, and presentation. Following an invitation from BMGF, a proposal was submitted in the spring of 2001.
Conclusions:
In June 2001, BMGF awarded a grant of US$70 million to create the Meningitis Vaccine Project (MVP) as a partnership between PATH and WHO, with the specific goal of developing an affordable MenA conjugate vaccine to eliminate MenA meningitis epidemics in Africa. EVA is an example of the use of WHO as an important convening instrument to facilitate new approaches to address major public health problems.
Insights
Developing an affordable group A meningococcal conjugate vaccine (MenA) is crucial for eliminating meningitis epidemics in Africa. This initiative, spearheaded by the Meningitis Vaccine Project (MVP), aims to provide a cost-effective solution to a persistent public health challenge.
Area of Science:
- Public Health
- Vaccinology
- Epidemiology
Background:
- Polysaccharide vaccines have historically shown limited success in controlling African meningitis epidemics due to logistical challenges with reactive vaccination campaigns.
- Major group A meningococcal meningitis outbreaks in 1996-1997 prompted African health ministers to prioritize meningitis prevention and seek WHO assistance.
- Existing vaccination strategies were insufficient, necessitating the development of improved immunization approaches to combat recurrent epidemics.
Purpose of the Study:
- To address the urgent need for effective meningitis epidemic control in Africa.
- To develop an affordable and impactful group A meningococcal conjugate vaccine (MenA).
- To establish a sustainable public-private partnership for vaccine development and implementation.
Main Methods:
- The World Health Organization (WHO) established the Epidemic Meningitis Vaccines for Africa (EVA) project to coordinate efforts.
- Collaborations included external consultants, PATH, the US Centers for Disease Control and Prevention (CDC), and the Bill & Melinda Gates Foundation (BMGF).
- Feasibility studies and cost analyses were conducted for group A or A/C conjugate vaccines, with input from African countries on preferred characteristics.
Main Results:
- Expert consultations recommended the development and introduction of a group A meningococcal conjugate vaccine.
- Cost analysis estimated the 'cost of goods' for a group A conjugate vaccine at US$0.35-$1.35 per dose.
- A proposal was submitted to BMGF in spring 2001, following their invitation.
Conclusions:
- The Meningitis Vaccine Project (MVP) was established in June 2001 with a US$70 million grant from BMGF.
- MVP is a partnership between PATH and WHO, focused on creating an affordable MenA conjugate vaccine.
- The project exemplifies WHO's role in convening stakeholders to address significant public health issues like meningitis epidemics.