Sample taking before vaccination in Burkina Faso. Paul Kristiansen is pictured second from left
MenAfriVac has the potential to significantly reduce disease and mortality in sub-Saharan Africa and eliminate devastating epidemics.
The first country-wide introduction of MenAfriVac will be launched in Burkina Faso on December 6, 2010. The vaccine was developed, tested and licensed by the Meningitis Vaccine Project (MVP), a partnership between the Program for Appropriate Technology in Health (PATH) and the World Health Organisation (WHO). The Norwegian Institute of Public Health (NIPH) has been one of the partners contributing to the project during phases of the clinical trials and is now also involved in monitoring the effect of the vaccine.
In sub-Saharan Africa, epidemics of serogroup A meningococcal meningitis caused by the bacterium Neisseria meningitidis are a major public health concern. Meningococcal meningitis can lead to severe hearing loss, mental retardation, epilepsy and death. The disease is transmitted by air-borne droplets from people who have the bacterium in their throat, but usually are without symptoms (asymptomatic carriers).
Public health officials in the sub-Saharan region asked WHO for help to develop an improved vaccine (a so-called conjugate vaccine, particularly effective in children under 2 years of age and giving long-lasting immunity) that must cost less than $US 0.50 per dose. Together with various international collaborators, including public health institutes and vaccine manufacturers, MVP was able to develop such an affordable vaccine that met international standards of quality, safety and efficacy.
From pilot to country-wide introduction
After a successful pilot vaccination of nearly 1.1 million people in Burkina Faso, Mali and Niger, all the remaining 1-29 years olds in Burkina Faso, i.e. 10 million people, will be offered the vaccine within a few weeks. By vaccinating such a large proportion of the population with a highly immunogenic vaccine, transmission of the disease-causing bacterium can be avoided.
“The people I work with in Burkina Faso have been hoping for a better vaccine for a long time now” said Paul Kristiansen, project manager at the NIPH. “They are really excited about the successful pilot and the country-wide implementation.”
The NIPH is a WHO Collaborating Centre for Reference and Research on Meningococci. The Centre is leading a study to monitor the ability of MenAfriVac to reduce carriage and thus, limit transmission of the disease. In collaboration with MVP, the Centers for Disease Control and Prevention (CDC) in the United States and the Ministry of Health in Burkina Faso, tens of thousand of 1-29 years olds from three districts of Burkina Faso have been already tested for meningococcal carriage. Samples have been taken at different time points before vaccination to account for natural seasonal fluctuations. Carriage prevalence will be monitored after vaccine introduction to see whether there is a reduction of the disease-causing bacterium in the population as a result of vaccination.
“This is the largest carriage study ever conducted in Africa and it was challenging to implement. It has been all about finding solutions to climatic and environmental challenges, administrative and logistical constraints, adapting the work to difficult working conditions and at the same time keeping the quality high at three locations over a long period of time” added Kristiansen.
The project also aims to improve the capacity and the quality control systems of the laboratories in Burkina Faso and contributes to meningitis surveillance.
“The hospitals in Burkina Faso are doing their best with the infrastructure they have but it is challenging. For instance, one of the district hospitals I visited only had electricity available for a few hours per day! This project has contributed to capacity building of the participating laboratories with training and equipment such as safety cabinets, incubators, refrigerators, bio freezers and air-conditioning” said Kristiansen.