Times of India
01 December 2010
By Kounteya Sinha
New Delhi, India

Come Monday, an indigenous vaccine will help rid Africa of meningitis, one of the dark continent’s worst enemies. Less than 10 years after the creation of the Meningitis Vaccine Project, the new vaccine – MenAfric–Vac – is ready to be introduced in Africa for mass immunisation.

MenAfriVac, the conjugate single dose vaccine that protects both children and adults, is developed by the Serum Institute of India (SII) in Pune.

It was licensed by the drug controller general of India in December 2009, prequalified by the World Health Organisation in June 2010 and registered in Niger, Mali and Burkina Faso earlier this year. Burkina Faso, Mali, and Niger have been selected for the first introduction of the vaccine on the basis of several criteria, including disease burden, the ability to organise mass campaigns and participation in clinical trials to develop the vaccine.

Countrywide vaccination campaigns of the population – in the 1–29 age group – in these three countries will begin on December 6.

More than 25 African nations – stretching from Ethiopia to Senegal – that fall under the region’s infamous meningitis belt, will use the vaccine to combat the life–threatening bacterial disease. Officials said, "In October, district level introduction of the vaccine on more than one million in Burkina Faso, Niger, and Mali was completed. In just 17 days, 1,038,457 were vaccinated. The mass vaccination will start on December 6."

Approximately 300 million will be targeted for mass vaccination across the meningitis belt, with the entire population (an estimated 450 million) then protected through the broader community protection that could reduce transmission of the disease.

The vaccine underwent Phase I clinical tests in Hyderabad and Mumbai, among adults (18–35 years) and proved safe, improving immune response.

The Phase II trials were then undertaken in Gambia and Mali where it showed almost 20 times higher antibody levels in one to two–year olds, compared to the existing polysaccharide vaccine. The Phase II/III clinical trials was then successfully completed in two– to 29–year olds in Gambia, Mali and Senegal.

The vaccine has a very interesting vial monitor. When health care workers uncap doses of the vaccine for the first countrywide vaccination campaigns, a small purple sticker will provide them with key information about the condition of the vaccine.

The little round dot is a vaccine vial monitor developed by PATH, an INGO, that shows if the vaccine has been exposed to excessive heat. The sticker changes colour as its exposure to heat increases over time, letting health workers know at a glance that the vaccine may no longer be effective.

In sub–Saharan Africa and developing countries around the world, keeping vaccines at safe storage temperatures (2–8 degrees Celsius) is an ongoing challenge. Hot weather, intermittent electricity and poor roads all pose threats to a vaccine’s potency.

The vaccine vial monitor helps health workers have confidence that the vaccine they are administering has not been damaged due to excessive heat.

Interestingly, the vaccine costs less than 50 cents. Dr S S Jadhav, executive director of SII, had earlier told TOI, "The vaccine will protect both adults and toddlers with a higher immune response than the currently available vaccine. The vaccine will also provide long–term protection and induces immunity in certain non–vaccinated persons who live in proximity of those who are immunised, leading to broad community protection."

Meningitis is the infection of meninges, which surrounds the brain and spinal chord

• In 2009, in sub–Saharan Africa, at least 88,000 were infected and 5,000 died
• Severely infected patients typically die within 24–48 hours of the onset of symptoms
• Among the survivors, 10% to 20% suffer brain damage, hearing loss or a learning disability
• Africa sees small epidemics of meningitis throughout the year
• In every 10 or 12 years, Africa faces an epidemic
• The last epidemic occurred in 1996–1997, leading to 20,000 deaths
• The disease killed more than 1,00,000 between 1988 and 1997