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Africa risks large meningitis outbreak


WHO• Nigeria, Niger record 12,000 cases, 800 deaths 

FOUR international public health organisations including the World Health Organisation (WHO), over the weekend, warned that with Africa at risk of a large meningitis outbreak, an acute shortage of meningitis C-containing vaccine threatens to severely limit the world’s ability to minimise the number of people affected.

International Federation of Red Cross and Red Crescent Societies (IFRC), Médecins sans Frontières (MSF), The United Nations Children’s Fund (UNICEF) and the WHO, which together constitute the International Coordinating Group for Vaccine Provision for Epidemic Meningitis Control (ICG) are therefore calling on vaccine manufacturers to step up meningitis C-containing vaccine production by five million doses before the 2016 meningitis season starts in January.

The group in a statement published yesterday by the WHO said while substantial progress has been made in recent years in protecting Africa from other main sub-types of meningitis with, for example, the introduction of the MenAfrVac vaccine against meningitis A in 2010, much work needs to be done to protect the African meningitis belt from meningitis C outbreaks.

International Medical Coordinator, MSF, Dr. Myriam Henkens, said: “In just the first six months of 2015, there have been 12,000 cases of meningitis C in Niger and Nigeria, and 800 deaths. At the same time, there has been a critical shortage of vaccine.

The campaigns consequently were limited to the critically affected age groups and areas, and even so, had to be delayed until vaccine supply became available and we believe next year will be worse.

We need vaccine manufacturers to plan production of multivalent vaccine now to allow sufficient lead time and capacity to meet this demand.”

But the Executive Director, National Primary Health Care Development Agency (NPHCDA), Dr. Ado Gana Muhammad, in an exclusive interview with The Guardian said: “You will recall that in December 2011 we introduced the Mening A vaccine initially in seven states targeting one to 29 years.

In 2012 we also took on additional seven states. By 2013 we have immunised all the states of the federation and that also is another strategy to make sure that we do not record any outbreak. “Before 2011 when it is meningitis season, there is panic because people will get morbid and thousands of people will die.

But we have not had any outbreak of meningitis since 2011 due to Mening A vaccine we have introduced. So all these are things we are putting in place to ensure that we contain and manage epidemic diseases while also ensuring that our routine immunisation system also works.”

Coordinator for Control of Epidemic Diseases Unit at WHO, Dr. William Perea, said: “Meningitis tends to hit Africa in cycles. Cases of meningitis C have been rising since 2013, first in Nigeria in 2013 and 2014, and then in Niger in 2015.

We have to be ready for a much larger number of cases during the 2016 meningitis season.” Health Specialist, Programme Division, UNICEF, Dr. Imran Mirza, said: “We have had preliminary discussions with vaccine manufacturers and impressed upon them the need to produce a stockpile of five million doses of vaccine so as to be ready for flare-ups of the disease next year in Africa, but so far they haven’t yet revised their production plans to meet demand.”

ICG Secretariat’s Mr. Alejandro Costa, said: “We have been working to reinforce detection and response systems, and are working to secure other sources of meningitis C vaccine in Cuba and Brazil, but the manufacturers have not yet submitted an application for WHO prequalification. “Until they do, we can only turn to those manufacturers who are already prequalified and have provided vaccine in the past. We need to get them to produce and provide vaccine, in the right quantity and at an affordable price.”

Senior Officer, Emergency Health, IFRC, Ms Amanda McClelland, said: “The ICG stresses that vaccination remains key to preventing meningitis.

Since the introduction of the meningitis A conjugate vaccine (MenAfriVac) in 2010 in 15 countries in Sub-Saharan Africa, the meningitis disease burden has been dramatically reduced. No epidemics of meningitis A have been reported in areas where the population has been vaccinated. We need now to do the same for meningitis C.”

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