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Africa's Meningitis Belt Gets First Vaccine Designed For Poor Nations

Public health triumphs like this don't come along every day.

An array of public and private health groups is launching a cheap new vaccine against bacterial meningitis the first ever designed for Africa. Before now, vaccines and most other medicines have been developed for wealthy markets and retrofitted, sometimes, for poorer nations.

That wasn't working in Africa's so-called meningitis belt -- a swath of 25 countries that stretches from Senegal on the Atlantic coast to Ethiopia on the Horn of Africa. Every winter, with the onset of the dry, dust-laden Harmattan winds, Central Africa braces for epidemics of bacterial meningitis.

One in 10 people dies. One in 4 survivors is left with deafness or more severe disability, including mental retardation, paralysis or seizures. Last year bacterial meningitis struck more than 88,000 people in the region. The disease causes high fever, terrible headache, and stiff neck. It's transmitted by sneezing, coughing, or sharing eating utensils.

Older meningitis vaccines weren't much help. First, they aren't targeted specifically against Group A meningococcus, the African strain. They don't provide lasting protection, and they don't prevent transmission of the bacterium to unvaccinated people. They also have a short shelflife and cost a lot.

The new vaccine solves those problems and costs less than 50 cents a dose.

Its pedigree is unique. After a massive meningitis epidemic struck Central Africa in the late 1990s, countries in the region along with scientists and health organizations called a decade ago for a low-cost vaccine targeted on the problem. The Bill and Melinda Gates Foundation provided a 10-year grant to establish the Meningitis Vaccine Project to make it happen.

Scientists at the US Food and Drug Administration figured out a way to link a surface sugar from the Group A meningococcus to a carrier protein, producing a so-called conjugate vaccine that triggers a more effective immune response. A nonprofit group called PATH arranged for a supply of raw materials.

The whole project cost less than $100 million – an incredible bargain compared to the $500 million or more usually needed to develop a vaccine.

And now the new vaccine is ready to be administered to tens of millions of people in the meningitis belt, beginning this month with Burkina Faso, a nation of 15 million in west-central Africa. By mid-January, the plan is to vaccinate 80 percent of the population.

Five other so-called hyperendemic countries -- Mali, Niger, Chad, Sudan and Ethiopia -- are next up. More than 450 million people live in these most-at-risk nations.

It won't be necessary to vaccinate everybody to made a huge difference in the incidence of meningitis in the region. If 300 million people get vaccinated, experts think that will protect the rest through what's called herd immunity.

But vaccinating 300 million people will cost around $570 million. So far African countries and donor nations have raised $95 million. In these times, no one can guess where the next $475 million will come from.

Copyright NPR 2018.

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