Revolutionary new vaccine: winning the battle against meningitis A

Interview on impact of new meningococcal A conjugate vaccine with Australian Médecins Sans Frontières medical advisor, Dr. Cathy Hewison.

This month sees the arrival of the first batches of a brand new vaccine against meningococcal meningitis in three African countries that could revolutionise the battle against a disease that claims so many lives each year in the so-called meningitis belt.

Year after year, Médecins Sans Frontières vaccination teams launch vast reactive campaigns against this bacterial disease that kills up to half of those infected if not treated. Millions have been vaccinated but because the present vaccine is not highly effective, vaccination teams have to return each time a new epidemic threatens.

Now, there may be a brighter future with the arrival of a more effective, longer lasting vaccine. Médecins Sans Frontières is taking part in the first pilot programmes in Niger, Mali and Burkina Faso. Laura McCullagh asks Australian Médecins Sans Frontières Medical Advisor Dr. Cathy Hewison, about the limitations of the current vaccine, the benefits of the new vaccine and her vision of a meningitis-free future in the region.

CH The current vaccine has served a purpose, however it’s not an ideal vaccine. The limits are that the length of its action is very short - protection lasts only up to three years. But its protection goes down with time from the very first year on, especially in small children who are not protected for a long time at all.

LM So what are the benefits of the new vaccine?

CH The big benefit is that the protection can last for 10 years which means that we vaccinate people before epidemics hit. This means that we can actually prevent epidemics. The other benefits are that it is more effective, more people are better protected and with just one vaccination. And an additional major benefit is that it can stop the transmission of the epidemic. The previous vaccine could protect an individual person but couldn’t prevent the transmission of the meningitis epidemic.

LM Does this mean an end to meningitis epidemics in this region then?

CH It could mean an end to epidemics of meningitis in this sero group and that is sero group A. There are other sero groups of meningitis that can trigger epidemics and other bacteria as well and this vaccine will not cover them.

LM How will this affect the activities Médecins Sans Frontières has been involved in with regards to vaccination for meningitis?

CH We will probably be involved now in the prevention of epidemics in terms of vaccinating an entire target population of a geographical region in advance of epidemics instead of running after epidemics wherever they may pop up during the epidemic season. But we should take on board that the roll-out of this new vaccine will take several years so we still have several years of combating the epidemics with the existing vaccines.  

LM What will the next steps be in terms of rolling this out?

CH The first three countries to be targeted are Burkina Faso, Niger and Mali and they will start the vaccination there on a small scale in September this year. Then after the roll-out, those three countries will be fully covered by the end of 2011. For the rest of the countries in the meningitis belt, there’s no plan as such in what order that will go. It will depend on the epidemiological situation in each country and the country readiness for a large immunisation campaign.

LM: What are the finances looking like right now?

CH  For the first three countries about 80 percent of the costs are covered but there’s a still a shortfall of about US$10 million for those first three countries. For the rest of the countries in the meningitis belt, it’s up to each country to find their own finance.

LM Evidently it’s a fantastic medical breakthrough that will have enormous impact on the communities involved?

CH  Yes, it’s going to have a massive impact. Every meningitis season -  which is the dry season going from January to about May -  the countries are on tenterhooks; they don’t know if there will be an epidemic or not. If there is one, it takes up a massive amount of resources, human and medical. And people are scared because both adults and children die of meningitis so it has a major economic as well as psychological impact on people.

LM As a medical doctor, how do you respond to this breakthrough?

CH It’s a miracle, a revolution, and I think that the project that developed this vaccine, tailored to the needs of the meningitis belt in Africa and at a price they could pay, is a breakthrough and should be used as an example for other problems of this sort.

For more information, visit http://www.msfaccess.org/main/vaccines/