Grace Ashiru
In a groundbreaking development, Nigeria has made history by being the first country to introduce the Men5CV vaccine, as recommended by the
World Health Organization (WHO). This vaccine provides protection against five strains of the meningococcus bacteria. The initiative, including the emergency vaccination efforts, is financially supported by Gavi, the Vaccine Alliance. Gavi funds the global meningitis vaccine stockpile and aids low-income nations in implementing routine meningitis vaccination programs.
Nigeria is situated in the African Meningitis Belt and is one of the 26 hyper-endemic countries for meningitis in Africa. Last year, there was a 50% increase in reported annual meningitis cases across the continent.
In Nigeria, an outbreak of Neisseria meningitidis (meningococcus) serogroup C has caused significant concern, with 1742 suspected cases of meningitis, including 101 confirmed cases and 153 tragic fatalities across seven Nigerian states (Adamawa, Bauchi, Gombe, Jigawa, Katsina, Yobe, Zamfara) between October 1, 2023, and March 11, 2024. To combat this lethal outbreak, a vaccination campaign targeting over one million individuals aged 1-29 years has been launched from March 25 to 28, 2024.
Meningitis is a grave infection that causes inflammation of the membranes surrounding the brain and spinal cord. It can be caused by various pathogens, such as viruses, bacteria, fungi, and parasites. Common symptoms include headache, fever, and a stiff neck. Bacterial meningitis is particularly severe and can lead to blood poisoning, potentially resulting in death or severe disability within 24 hours of contracting the infection.
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, expressed optimism about the potential of the new meningitis vaccine to alter the course of the disease, thereby preventing future outbreaks and saving countless lives. He highlighted Nigeria’s rollout as a significant step towards the goal of eradicating meningitis by 2030.
The new vaccine is a game-changer, offering robust protection against all five major strains of the meningococcal bacteria (A, C, W, Y, and X) in a single shot. These strains are responsible for causing meningitis and blood poisoning. This broader protection surpasses the current vaccine widely used in Africa, which is effective only against the A strain.
The new vaccine holds promise in substantially lowering the incidence of meningitis and driving advancements in combating the disease. This is particularly crucial for nations such as Nigeria, where various serogroups are widespread. Leveraging the same technology as the successful meningitis A conjugate vaccine (MenAfriVac®), which eradicated meningococcal A epidemics in Nigeria, the new vaccine is poised to make a significant impact.
Northern Nigeria, particularly the states of Jigawa, Bauchi, and Yobe, has been severely affected by a deadly meningitis outbreak. According to Prof. Muhammad Ali Pate of the Nigerian Ministry of Health and Social Welfare, the introduction of this vaccine equips health workers with a new tool to not only halt the current outbreak but also work towards eliminating the disease in the country. Prof. Pate highlighted the extensive preparations undertaken to ready health workers and the healthcare system for the vaccine rollout. He also expressed gratitude for the support received from the community, especially during the fasting period, and from influential leaders such as the Emir of Gumel in Jigawa state, who personally launched the vaccination campaign. Close monitoring of progress is planned, with hopes of expanding the immunization efforts in the coming months and years to accelerate overall progress.
The development of this groundbreaking multivalent conjugate vaccine spanned over 13 years and was the result of a collaborative effort between PATH and the Serum Institute of India. The crucial financial support from the UK government’s Foreign, Commonwealth and Development Office played a pivotal role in its successful development.
In July 2023, the World Health Organization (WHO) granted prequalification to the new Men5CV vaccine, branded as MenFive®. Subsequently, in October 2023, WHO officially recommended countries to introduce this new vaccine. Gavi, in December 2023, allocated resources for the Men5CV rollout. Currently, the vaccine is available for outbreak response through the emergency stockpile managed by the International Coordinating Group (ICG) on Vaccine Provision. Mass preventive campaigns for the rollout of Men5CV are anticipated to commence in 2025 across the countries of the Meningitis Belt.
“The distribution of one million vaccines in northern Nigeria will significantly contribute to saving lives, preventing long-term illness, and advancing our global objective of eradicating meningitis by 2030,” stated Andrew Mitchell, UK Minister for Development and Africa. “This exemplifies the type of scientific advancement, backed by the UK, that I anticipate will be replicated in the future to facilitate further progress, potentially leading to the elimination of other diseases.”
The World Health Organization (WHO) has been providing crucial support to the Nigeria Centre for Disease Control and Prevention (NCDC) in tackling the meningitis outbreak in the country. This support encompasses disease surveillance, active case identification, sample testing, and case management. Additionally, WHO and its partners have played a pivotal role in assisting Nigeria in preparing for the introduction of the new vaccine and in training healthcare workers.
“Year after year, meningococcal meningitis has been a persistent challenge for countries across Africa,” remarked Dr. Nanthalile Mugala, PATH’s Chief of Africa Region
“The launch of MenFive® in Nigeria marks a significant turning point in the battle against meningococcal meningitis in Africa. Building on the foundation of past vaccination initiatives, this achievement is a testament to more than a decade of steadfast and innovative collaborations. The potential of MenFive® extends beyond its immediate impact, offering hope for the protection of numerous lives in the years ahead, bringing us closer to a future free from the threat of this disease.”
In 2019, the World Health Organization (WHO) and its partners unveiled the global roadmap aimed at eradicating meningitis by 2030. This strategic plan outlines a holistic approach to achieving a world without meningitis and is centered on three key objectives.
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Preventing Bacterial Meningitis Epidemics
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To reduce cases of vaccine-preventable bacterial meningitis by 50% and decrease deaths by 70%.
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Our goal is to enhance the quality of life and minimize disability following meningitis of any origin.
Aurélia Nguyen, the Chief Programme Officer at Gavi, the Vaccine Alliance, emphasized the importance of innovative solutions like MenFive® in combatting the increasing outbreaks of infectious diseases globally. Nguyen highlighted the significance of the first MenFive® shipment, which marks the initiation of Gavi’s support for a multivalent meningococcal conjugate vaccine (MMCV) program.
This program, with essential donor funding for the next five years, aims to introduce pentavalent meningococcal conjugate vaccines in high-risk countries. The successful elimination of meningitis A outbreaks in Africa through vaccination has underscored the potential of vaccines in preventing long-term disability and fatalities. Gavi’s commitment to addressing other serogroups causing large outbreaks aligns with its mission to mitigate the impact of infectious diseases worldwide.
Following the successful meningitis vaccine campaign in Nigeria, a significant milestone in the fight against meningitis is the upcoming international summit on meningitis in Paris in April 2024. This summit will bring together global leaders to celebrate achievements, identify remaining challenges, and strategize for the future. It presents an important opportunity for country leaders and key partners to make political and financial commitments to expedite progress towards eliminating meningitis as a public health threat by 2030.
