Geneva, 6 February 2011 — Médecins Sans Frontières (MSF) welcomes the new trivalent (ACW135) meningitis vaccine developed by GlaxoSmithKline. MSF is particularly encouraged to see that the new product was registered so quickly, in only a few months, while last August, companies and regulatory authorities still argued such a quick maneuver wouldn't be feasible.
"This shows that a lot is possible when the will is there. With the new vaccine, we can counter the emergence of the W135 strain of meningitis in Africa," says Dr Bernard Pécoul, Director of the MSF Campaign for Access to Essential Medicines. "Burkina Faso already reports over 1,300 cases since last December, the majority of them W135. If there is an epidemic on a national level, Burkina Faso will need about 3 million doses of the new vaccine," Pécoul said.
If the W135 strain spreads to other countries in the African meningitis belt, the need could be as many as 20-50 million doses in the next five years — meaning that with only three million doses available, there will be a significant shortfall. MSF is concerned that reliance on one producer in such a situation is unwise. However, Aventis Pasteur, the second global producer of meningitis vaccines, has not taken up the challenge to become part of the solution.
There has also been a striking lack of financial support from wealthy countries in making vaccines available. Apart from the Gates Foundation's private funding, only Norway has pledged funds in the international response to meningitis in Africa, estimated by WHO and its partners to require 10 million euro. "Support from the Gates Foundation is welcome but covering global public health needs is the job of governments," Dr Pécoul said.
GSK is selling the three million doses at USD 1.50 a dose, which is too high a price for the African countries affected. MSF is calling for a vaccine at less than a dollar per dose.
WHO press release: Partnership moves in record time to provide vaccine against meningitis as epidemic emerges in Africa
Speeding up what is usually a years long process, the World Health Organization (WHO), GlaxoSmithKline and the Bill & Melinda Gates Foundation are making a new meningitis vaccine available to African countries just months after an emerging epidemic of a new strain of the disease was discovered. The ACW135 vaccine will cover the typical meningitis strains found in Africa (A and C) as well as the W135, a strain found only in sporadic cases on the continent until last year, when it affected 14,453 people and killed 1,743 in Burkina Faso.
100,000 doses of the new vaccine are being shipped to Burkina Faso, where 1,349 cases of W135 meningitis have already been confirmed, out of which 244 people have died.
The overall initial supply of the vaccine - 3 million doses - will be made available at reduced cost for the African meningitis belt (an area comprising 21 countries stretching from Ethiopia in the east to Senegal in the west), in response to need over the coming months.
"The record time in which we've come up with a vaccine and are making it available to those who need it is a testament to the fact that public-private partnerships can work for the betterment of health," says Gro Harlem Brundtland, Director-General of WHO.
Meningitis is a killer disease affecting mostly children. Fever, nausea and headache can progress rapidly to cause serious neurological damage, deafness, coma and death. Unless treated, up to half of those infected will die. Even with treatment, as many as 20% of patients do not survive.
Meningitis outbreaks occur almost every year during the dry season in the African meningitis belt. The crucial epidemic period is usually in the first months of the year. In 2002 alone, there were at least 44,280 cases and 5,531 deaths reported to WHO's surveillance systems in the African region.
"It is possible that the W135 strain will not remain contained in Burkina Faso, but that it will spread to other countries in the meningitis belt, just like the A strain did 15 years ago", explains Daniel Tarantola, Director of Vaccines and Biologicals at WHO. "But we have great hopes that this newly formulated vaccine will save many lives and we are working on other vaccines that may, in the years to come, break the cycle of death and illness due to meningitis in this area."
In response to the unexpected W135 outbreak in 2002, WHO sounded the alarm to the pharmaceutical industry, asking their assistance to make a trivalent vaccine available at an affordable price. GSK responded favourably and developed the vaccine in just a few months. The Gates Foundation granted most of the necessary funds to buy the vaccine.
Until now, only a quadrivalent vaccine covering the W135 strain was available, but its cost of between US$ 5 and US$ 50 per dose meant that it was out of reach of those countries where it was most needed. The new vaccine is available at US$ 1.50 per dose once delivered to countries in the meningitis belt taking part in an impact evaluation due to begin this month. The Belgian National Regulatory Authority has already licensed the vaccine for international use.
The vaccine is being distributed through the International Coordinating Group on Vaccine Provision for Epidemic Meningitis Control (ICG), which was created by WHO in 1997. Countries wishing to obtain the vaccine must submit a formal request to the ICG, which also includes the International Federation of Red Cross and Red Crescent Societies, Médecins Sans Frontières and UNICEF. The requests are reviewed and vaccine distributed only to those countries which meet key epidemiological and operational criteria established by the ICG, which can be found on firstname.lastname@example.org.
On 7th November 2002, IFRC, MSF, UNICEF and WHO launched an emergency appeal for 10 million Euros needed now to prepare for a deadly new strain of meningitis in Africa.