Abstract

For over 100 years, large epidemics of meningococcal meningitis, involving many thousands of subjects, have occurred in an area of the African Sahel and sub-Sahel known as the African meningitis belt, which stretches across Africa from Ethiopia in the east to Senegal in the west. Theories as to how the bacterium which causes these epidemics (Neisseria meningitidis – the meningococcus) reached sub-Saharan Africa will be discussed as will possible reasons for why meningococcal infection occurs in this part of Africa in a manner seen nowhere else in the world. The features of the disease and its treatment will be mentioned briefly. Attempts to prevent this infection by vaccination have been made since shortly after the infection was described first in Africa but, until recently, these efforts have met with only limited success. With support from the Bill and Melinda Gates Foundation, a new serogroup A polysaccharide protein conjugate vaccine (MenAfriVac) has been developed through a public private partnership (the Meningitis Vaccine Project) and produced at the Serum Institute of India at an affordable price. This vaccine is now being rolled out across the meningitis, and recent experience in Chad which has shown that it has been dramatically effective in averting an epidemic will be described.