meningitis

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Visualizing a vaccine breaking new ground, and chains, in Africa | 

Guest post by Katie Leach-Kemon, a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.

A child in Burkina Faso receives a vaccination against meningitis.
A child in Burkina Faso receives a vaccination against meningitis.
WHO, PATH

One of the biggest obstacles to expanding immunization to the remotest regions on the planet has been that vaccines must be kept refrigerated at low temperatures.

Keeping vaccines cool during their entire trek – from the manufacturer to a ship or airplane to a refrigerated truck down to the guy riding a bicycle with a cooler – is known as the ‘cold chain.’

A new vaccine created by Seattle-based PATH, with help from the World Health Organization and other partners, now indicates it may be possible to break free from these chains.

The vaccine, known as MenAfriVac, was designed specifically for the ‘meningitis belt’ of central Africa – a region that had seen tens of thousands of annual deaths from this disease, not to mention the survivors left brain damaged, deaf or otherwise disabled.

map-meningitis-belt-engSince the new vaccine campaign began, more than 150 million people have been vaccinated and disease rates have fallen significantly. Africa’s so-called ‘meningitis belt’ may soon disappear.

In addition, a new study of the vaccine’s use in the field is being hailed by some as evidence the cold chain may also soon go the way of horse-and-buggy. Continue reading

PATH’s meningitis vaccine project on Good Morning America | 

PATH’s meningitis vaccine project was featured on ABC’s Good Morning America show on Memorial Day:

Here’s my post from early December, when PATH, the World Health Organization, UNICEF and other partners started immunizing in Burkina Faso, the culmination of a decade-long struggle to develop an inexpensive meningitis vaccine designed for use only against an epidemic strain in Africa.

While the immunization campaign is impressive, having already protected some 20 million people, the real game-changer here was the demonstration by PATH (with funding from the Gates Foundation) that it was feasible to develop a new vaccine of benefit only to poor communities at a cost — about 50 cents — they could afford. I wrote a bit more about this project recently in a story on PATH’s 34th anniversary.

The GooMoAmerica story, as part of ABC’s Be The Change: Save A Life series, was also funded by the Gates Foundation. ABC, to its credit, mentioned this in its report.

Some are disturbed about the extent to which the Seattle philanthropy, which of course is a big player itself in global health, is funding media coverage of global health. The Gates Foundation says it takes a hands-off approach and is just trying to encourage more coverage of neglected issues.

PATH celebrates 34 years of life-saving gizmos | 

Seattle-based PATH today celebrated 34 years of finding creative ways to use science and technology to save millions of lives, mostly children, and one achievement this year that was unusually ground-breaking.

A vaccine made only for poor people.

That sounds simple enough, but it isn’t. Vaccines have to be made by the drug industry and industry needs to make money. In central Africa, a particular strain of meningitis has for generations killed, maimed and terrified communities from Senegal to Ethiopia.

Developing a vaccine against this bacteria was long possible, but the drug industry saw no market for it. This disease was too geographically specific and the people (or the governments) too poor to be able to afford a “designer” vaccine.

But, as I posted on last December, PATH’s Marc LaForce was determined to get this vaccine made and paid for because the well-being of millions of Africans depended upon it.

“It took 10 years to develop this vaccine,” LaForce said today at PATH’s annual fundraising Breakfast for Global Health event, this year held art Bell Harbor. It took financial as well as technical innovation, as described on PATH’s web site.

In Burkina Faso, where the vaccination campaign started this winter and which used to see thousands of cases of bacterial meningitis, LaForce said this year “there has been only one case.” At the PATH breakfast, St. Joseph’s choir mimicked the sound of rain — end of meningitis season — to celebrate the achievement.

Tom Paulson

St. Joseph's Choir, mimicking the sound of rain and end of meningitis season

Chris Elias, president of PATH, said some 20 million children and young adults have been vaccinated so far with assistance from UNICEF, Doctors Without Borders, the World Health Organization, countless health workers in Africa and, most recently, with $100 million in new funding to expand coverage from the Global Alliance for Vaccines and Immunization.

That is in itself an amazing success story, he said, but what makes PATH’s Meningitis Vaccine Project “one of the most important milestones in public health” is how they demonstrated that a vaccine of use only to poor countries could, in fact, be produced cheaply (about $.50 a dose) and profitably by industry.

Another milestone celebrated at the PATH breakfast today was a reunion of the founders of PATH, Gordon Duncan, Richard Mahoney and Gordon Perkin. The three started PATH (which initially went by a different, much less phonetic, name) primarily to work on improving maternal health in poor countries.

PATH, which today is one of the world leaders in the burgeoning field of global health, didn’t always have it so easy. I can remember going to visit them in the 1980s in their non-descript building on the Lake Washington ship canal, working on projects in cramped and hardly luxurious settings. At one point, they were even at risk of going out of business due to cuts in donor funding.

But they persevered, moving into new areas with technological solutions or improvements focused on problems in vaccination, water safety and other health needs. Eventually, PATH caught the eye of the (at the time new) Bill & Melinda Gates Foundation. The rest, as they say, is history.

“We just happened to be in the right place at the right time,” said Richard Mahoney, who is now working on a (Gates-funded) project in South Korea, the Dengue Vaccine Initiative.

Tom Paulson

PATH founders Richard Mahoney, Gordon Duncan and Gordon Perkin

Bill Gates pushes world health assembly to boost vaccinations | 

It’s a simple thing, a vaccine.

But the simple lack of a vaccine in a poor community can bring death, heartache and even financial ruin to a family. It does, every day, with a yearly toll in the millions, mostly child deaths.

UN

Bill Gates at World Health Assembly

“That was a sobering realization for me,” said Bill Gates, speaking today to the World Health Assembly and representatives of 193 member states.

Gates recalled when in 1998 he first read about rotavirus, hadn’t heard of it, and was stunned to learn the bug was killing half a million kids every year. He kept reading about vaccines and one of the primary missions of the Seattle philanthropy took shape.

“Thirty years ago, my colleagues and I envisioned a computer on every desktop,” Gates said. Now, what he’d be even more excited to see is that every child, anywhere in the world, has access to these inexpensive, basic tools of health.

“Vaccines are an extremely elegant technology,” he said. “They are inexpensive, easy to deliver and are proven to protect children from disease. At Microsoft, we dreamed about technologies that were so powerful and simple.”

Gates called upon those in attendance and world leaders to commit to expanding the use of vaccines in recognition that they are the most powerful means for achieving health.

Just by assuring every child is vaccinated (or more realistically, 90 percent), he said we can finally eradicate polio. Just by getting the basic vaccines out to the majority of children in the world would prevent millions of easily preventable child deaths every year. Families can avoid the tragic loss of a child and the sometimes terribly costly care, or loss of labor, that can tip them into poverty.

Many developing nations are already reaching the 90 percent mark, Gates said, citing Bangladesh, Nicaragua, Rwanda and Vietnam. Yet there are places where children never see a single vaccine, he said.

Gates wanted his audience to imagine what the world would be like if we could get this cheap, simple tool out there to every child. He talked about the polio campaign and urged everyone to stick it out. He mentioned PATH’s new meningitis vaccine project as an example of how innovative financing made it feasible to get a life-saving vaccine out to some of the poorest parts of Africa. Here is a synopsis of his vision.

Progress is being made through initiatives like GAVI, the Global Alliance for Vaccines and Immunization, Gates said. But funding for GAVI is so far insufficient, progress is fragile and won’t be sustainable without greater support and investment from donors and governments, he said.

Gates called upon those gathered at the World Health Assembly to take some specific actions:

  1. Donor countries, you must increase your investment in vaccines and immunization, even though you are coping with budget crises. The GAVI Pledging meeting next month gives you and your governments the opportunity to show your support.
  2. Pharmaceutical companies, you must make sure vaccines are affordable for poor countries. Specifically, you must make a commitment to tiered pricing.
  3. All 193 member states, you must make vaccines a central focus of your health systems, to ensure that all your children have access to existing vaccines now—and to new ones as they become available.

If donors are generous, Gates said, we can prevent 4 million deaths by 2015 and, by 2020, we can prevent 10 million deaths.

“Together, and with your leadership, we can make this the decade in which we take full advantage of the technology of vaccines. When we do it, we will build an entirely new future based on the understanding that global health is the cornerstone of global prosperity.”

Vote PATH’s Marc LaForce to the top of TIME’s Top 100! | 

Every year, TIME magazine publishes its list of top 100 most influential leaders, thinkers, artists and innovators for the year.

Many of them are the same old celebrities (not in rehab), politicians, rich people and other luminaries any of us could choose based on a Google search or conversation around the table. Some of them just turn out to be idiots who accidentally did something significant, or “innovators” who will later be convicted of a crime.

But some of those in TIME’s top 100 list are indeed doing good and great things, making the world a better place. Many of these are already pretty well-known.

PATH

Marc LaForce

That’s why it’s so great to see that a soft-spoken physician who has cared more about helping the poorest of the poor than about gaining personal recognition is on TIME’s radar screen. PATH’s Marc LaForce is in the running, currently ranked as 46th!

I want everyone who believes that saving kids’ lives and helping the poor is more important than the “influential” work of Lady Gaga, Glenn Beck or Han Han (a Chinese race car driver) to vote for Mark LaForce.

Basically, LaForce stubbornly worked for more than a decade to develop an inexpensive vaccine against a form of meningitis that is a terror in central Africa.

The trick was getting it made cheap enough. No easy trick.

Here’s a story about the culmination of LaForce’s work — the launch of the meningitis vaccine project last December in Burkina Faso. The initiative is run by PATH and the World Health Organization with funding from the Bill & Melinda Gates Foundation.

Here’s what TIME magazine said:

LaForce is director of the Meningitis Vaccine Project, a project funded by the Bill and Melinda Gates Foundation that last year began distribution in Mali, Burkina Faso and Niger of the first low-cost vaccine for meningococcal meningitis A, a disease that reaches epidemic proportions across northern Africa’s “meningitis belt” every December. The disease kills about 10% of those who contract it — some 450 million people are at risk — and leaves some 20% of survivors severely disabled. The vaccine, called MenAfriVac, costs just 40 cents a dose. To date, some 19.5 million people have received it.

Wikileaks describes drug maker “dirty tricks” during Nigerian meningitis outbreak | 

One of the events that prompted PATH and WHO to launch the Meningitis Vaccine Project 10 years ago, and which just started in earnest this week, was a massive African outbreak of this terrifying disease in 1996.

In the middle of Africa’s meningitis belt during that huge outbreak, drug maker Pfizer decided to test a new medication for its ability to protect against this bacterial infection. This was in the northern Nigerian city Kano.

This episode became a scandal, one that many have forgotten but now has been resurfaced by Wikileaks and reported by The Guardian:

The world’s biggest pharmaceutical company hired investigators to unearth evidence of corruption against the Nigerian attorney general in order to persuade him to drop legal action over a controversial drug trial involving children with meningitis, according to a leaked US embassy cable.

The clinical study, which Pfizer said did appear to reduce the death rate in the treated children (all children were treated, with the new drug and others with standard therapies), had been criticized by others such as Doctors Without Borders as “opportunistic” and unethical.

Nigerian officials investigated and eventually charged Pfizer with causing harm to the treated children, charges that have since been dropped.

The BBC today reported that Pfizer denies engaging in any “dirty tricks” regarding this case. Here is Pfizer’s statement in response to the Guardian’s report on the Wikileaks documents.

PATH, WHO and others launch a “revolution” to end Africa’s meningitis epidemics | 

CDC

Meningitis Belt

Today could be the beginning of the end of a deadly and disabling epidemic of bacterial disease that, for reasons not fully understood, occasionally burns an exceptionally tragic swath across central sub-Saharan Africa from Senegal to Ethiopia.

The “meningitis belt.”

Starting today, PATH, the World Health Organization and a host of other partners begin fanning out across Burkina Faso, then to Mali and Niger to launch a massive vaccination campaign initially targeting 20 million people with the broader aim — if it gets fully funded — of ending these epidemics in 22 more countries and erasing this stripe of death and destruction.

“When these major meningitis outbreaks occur in these communities, it’s terrifying and everyone just stays inside … they just shut down,” said Dr. Marc LaForce, director of the Meningitis Vaccine Project.

Meningitis can be caused by any number of things. The term simply means an inflammation of the brain and spinal cord, an inflammation that can kill, cause brain damage, deafen or otherwise disable. In Africa’s meningitis belt, LaForce explained, the cause is a particular bacteria known as meningococcal A.

Meningitis can occur anywhere, but not like in the meningitis belt, LaForce said. Continue reading