December 2, 2002
Aid agencies have launched an urgent appeal for EUR10 million (US$10 million) to control a new strain of meningitis that was initially reported among pilgrims to Mecca and now threatens a large swathe of Africa.
The World Health Organization, U.N. Children's Fund, Medecins Sans Frontieres (MSF) and the International Red Cross warned that, without funds for the vaccine, "thousands of people will certainly die unnecessarily." They said they were holding talks with manufacturers to try to bring down the cost of the life-saving shots.
Meningitis is a bacterial infection of membranes around the brain and spinal cord that is spread through close contact with an infected person. About half of those who become infected but do not receive treatment die, and the rest are often left with permanent disability. Children are most at risk.
Africa's "meningitis belt" stretches from Ethiopia to Senegal. In the last meningitis season, there were 33,000 cases and 2500 deaths, of which 1500 were in Burkino Faso.
The most serious epidemics usually occur every 6-8 years. The largest outbreak in history was in 1996, when 200,000 people - most of them children - were infected and 20,000 died.
"We are now entering a window where we can expect a big one. We could well have a large epidemic in front of us," said WHO's Guenael Rodier. The next meningitis season is expected early next year.
Of particular concern to health experts is the emergence of a new strain - W135 - which was found 2 years ago in Saudi Arabia and was spread to other countries by Muslims returning from the annual Hajj pilgrimage. The W135 strain was responsible for last season's deaths in Burkino Faso.
Although a vaccine exists to protect against W135, it is only produced as part of a vaccine against four strains of the disease - A, C, W135 and Y. Y is found only in industrialized countries. The vaccine costs between US$4 in the Middle East and US$50 in the United States.
"It's too expensive for countries and too expensive for MSF," said Bernard Pecoul, an expert with the group also known as Doctors Without Borders. He said MSF had to stop treatment in Burkino Faso last year because it had no suitable supplies.
The vaccine usually used in Africa costs only 25 cents per dose, but that only protects against strains A and C, which traditionally affect the continent.
David Heymann, head of WHO's communicable disease division, said the health agency hoped to reach agreement with the manufacturers for a cheaper multiple-strain version costing about US$1. This could be achieved by dropping the Y strain from the vaccine as this doesn't pose a risk in Africa.
The two main manufacturers are GlaxoSmithKline and Aventis Pasteur.
Saudi Arabia has insisted that everyone making the journey to the next Hajj - the pilgrimage that all Muslims are expected to make once in a lifetime - must be vaccinated.
Heymann said WHO needed the money up front to enable countries at risk to purchase advance stocks of vaccine rather than having to wait until the epidemic has started. A meeting of donor governments was scheduled to discuss the appeal. This article was prepared by TB & Outbreaks Week editors from staff and other reports.
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