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For more information on the vaccine development process, visit the Meningitis Vaccine Project website. Photo: PATH.

The World Health Organization, PATH, and the Bill & Melinda Gates Foundation answer African leaders’ call for a solution

In 1996 and 1997, as the largest meningitis epidemic in African history swept across sub-Saharan Africa, 25,000 people died. It was the final straw.

After a century of living through recurrent meningitis outbreaks plus 30 years of experience with a logistically difficult polysaccharide vaccine, the epidemics were growing more deadly. African ministers of health knew that something needed to be done. They turned to the World Health Organization (WHO) for a solution.

The birth of the Meningitis Vaccine Project

WHO responded to the African ministers by bringing together global health leaders to discuss developing a new, more potent vaccine—one that could provide long-lasting protection against meningitis in Africa and could be used preventively. In 2000, delegates from African and Eastern Mediterranean countries, multilateral organizations, vaccine manufacturers, and the scientific community determined that developing a low-cost conjugate vaccine to fight group A Neisseria meningitidis, the leading cause of the epidemics in the meningitis belt, was indeed possible—and that it was a priority.

A year later, the Bill & Melinda Gates Foundation provided a ten-year grant to establish the Meningitis Vaccine Project (MVP), a partnership between PATH and WHO that would lead the development, testing, licensure, and widespread introduction of a conjugate vaccine with the promise of protecting millions of lives from group A meningococcal meningitis.

MVP director Dr. Marc LaForce describes how PATH and WHO became a virtual vaccine company. “We had nothing,” he says. “Our challenge was to translate that nothingness into a product.” Video: PATH.

A tall order

Although the scientific experts convened by WHO believed a conjugate meningitis vaccine could become a reality, the challenge for MVP was daunting. How would this partnership between two public health organizations gain access to and license a conjugate vaccine technology? And moreover, how would it be able to develop a vaccine that the countries of the meningitis belt could afford?

“Please don’t give us a vaccine that we can’t afford.”

In 2001, newly appointed MVP director Dr. Marc LaForce met with African public health officials to talk about the vaccine, and the question of cost came clearly to the forefront. “Please don’t give us a vaccine that we can’t afford,” an official from Niger told LaForce. “That’s worse than no vaccine.”

The officials made it clear that the vaccine needed to cost less than US$0.50 per dose to be sustainable in the countries where it would be used. But as the MVP team began meeting with pharmaceutical companies to discuss developing an affordable conjugate meningitis vaccine, LaForce and others soon realized that no one in the developed world could produce it at the desired cost. They began exploring alternatives.

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