When an international team of health care experts gathered 12 years ago to begin developing a new vaccine to combat meningitis, one of Africa's deadliest diseases, one requirement stood out among all others. African officials warned members of the Meningitis Vaccine Project, or MVP, that cost was just as important as efficacy. “Please don’t give us a vaccine that we can’t afford,” said an official from Niger, one of the most impoverished countries on earth. “That’s worse than no vaccine.”
That requirement imposed severe constraints on the ambitious project, but it appears MVP has succeeded in its mission. Its vaccine, called MenAfriVac, performed brilliantly in clinical trials, results of which were published Thursday in the Lancet medical journal. In three regions of Chad where the vaccine was administered last year, the incidence of meningitis amounted to 2.48 cases for every 100,000 people (57 cases in total), compared with 43.8 cases per 100,000 (3,800 cases) where the vaccine was not administered. Of the 57 people who did come down with the disease after receiving the vaccine, none had contracted meningococcal A, the most common strain, which the vaccine had been designed to prevent.
In short, MenAfriVac was an astounding success; health care professionals the world over believe this could finally vanquish one of Africa's most persistent, destructive diseases. And best of all, each dose costs around $0.50. MVP is a partnership between the World Health Organization and PATH, a Seattle-based nonprofit health care development organization. The group realized early on that it wouldn't be able to rely on major pharmaceutical companies to churn out its life-saving vaccine -- the costs would be too great. Instead, research was funded by the Bill & Melinda Gates Foundation, Médecins Sans Frontières and the Wellcome Trust, a British charity.
In order to manufacture the key ingredients of the vaccine MVP they turned to working with smaller organizations like Synco Bio Partners, a Dutch biotechnology firm, and the Serum Institute of India, a vaccine manufacturer. The next challenge was to access the technology required to turn those ingredients into a working vaccine. For that, MVP worked with the Center for Biologics Evaluation and Research, or CBER, at the U.S. Food and Drug Administration, where scientists helped MVP to adapt the necessary technology to its project despite a tricky intellectual property landscape.
Over the past decade, MVP and its partners have gone through research, production, pre-qualifications and trial runs -- and now, their new low-cost vaccine is saving lives. "MenAfriVac was developed at a major cost savings—less than one-tenth the cost of the $500 million typically needed to bring a new vaccine to market," according to PATH. "In addition, the reduction in meningitis cases is expected to free up significant funds that countries can use to address other public health problems."
Meningitis is a recurring scourge in Africa. Most outbreaks occur from January through May -- the dry season -- in a swath of land stretching from Senegal to Ethiopia, called the "Meningitis Belt." During this year's dry season, WHO reported 9,249 suspected meningitis cases and 857 deaths in 18 of the most at-risk countries. Massive outbreaks occur every eight to 12 years and can last for more than one season; the worst on record was in 1996-97, when more than 250,000 people were infected and at least 25,000 died. Meningitis symptoms include headache, stiff neck and fever, and the disease can result in life-long health or development problems in survivors. Because it disrupts livelihoods, meningitis also poses a threat to societal development on a grand scale.
"The debilitation and killing of so many working-age adolescents and young adults causes very significant human, social and economic losses to the affected communities," according to CBER. "A single case of meningitis can drive a family into poverty."
Now that MenAfriVac has proven itself so ably in Chad and a couple of smaller-scale trial locations, MVP hopes to expand treatment all across the Meningitis Belt. At $0.50 per dose, the vaccine is not only life-saving, but affordable -- and that makes it more effective than any high-priced treatment could ever hope to be.