To respond to this challenging situation and to the expected spread of the disease, WHO, in collaboration with its Member States and various governmental and nongovernmental agencies, has developed a sustainable plan of action for preparedness and control of meningococcal disease in African and Eastern Mediterranean Regions.
This initiative focuses on strengthening national and regional health systems in the following key areas:
- epidemiological surveillance for timely detection of outbreaks of unusual /increased incidence of the disease
- laboratory capacity for diagnosis of communicable diseases and rapid confirmation of outbreaks
- creation of a contingency stock of vaccine, drugs and injection materials and establishment of a revolving fund to ensure immediate availability of these materials in emergencies
- production of guidelines for the use of vaccine and protocols for appropriate case management
- establishment/activation of mechanisms for the coordination of the epidemic response.
While this international initiative was triggered in response to a crisis in vaccine supply for the control of severe epidemics of meningitis in Africa, it now ensures advance preparation for epidemics, with better surveillance to detect outbreaks promptly, and supplies ready for immediate dispatch to affected countries.
Sudan: A major epidemic in 1999
In 1999, about 60 000 cases of meningococcal disease were reported in Africa of which over 33 000 cases occurred in Sudan.
Assessing the situation associated with an outbreak identified early in the epidemic season, the Ministry of Health together with the International Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis Control worked out a contingency plan. A national ad hoc task force that mobilized funds to facilitate vaccine availability was activated. As a result, strategies for containing the epidemic were developed which made the most rapid and effective use of available resources. WHO worked to:
- strengthen surveillance system including the laboratory system
- provide vaccines drugs and diagnostic reagents including 1.6 million doses of vaccine
- provided technical experts over a 5-month period
The Sahel - Burkina Faso, Cameroon, Chad, Ethiopia and Niger: Urgently needed vaccines to fight a regional epidemic of meningococcal meningitis in 2001
Under the auspices of the ICG, WHO, UNICEF, Médecins sans Frontières, the International Federation of the Red Cross and Red Crescent Societies and the pharmaceutical industry, reviewed and analysed the needs, and rapidly distributed more than 7 million doses of meningococcal meningitis vaccine to fill gaps in vaccine provision in the most severely affected countries – Burkina Faso, Cameroon, Chad, Ethiopia and Niger. The timely provision of vaccines was crucial to control and prevent the spread of a severe regional epidemic and save the lives of thousands of children.
Burkina Faso: The emergence of W135 serogroup in 2002
An outbreak began in January 2002 in the southeast of the country, spreading to 30 out of 53 districts in the country and resulted in over 13 000 cases and more than 1400 deaths. N.meningitidis W135 was identified in 84% of the positive specimens processed. A mass vaccination campaign was not possible as only a vaccine for serogroup A and C was available; there was no vaccine available to protect the population at risk against W135. Case management became the cornerstone of the control strategy; stocks of oily chloramphemicol, an effective and affordable antibiotic for meningoccocal meningitis were pre-positioned at all treating health facilities of the affected districts. The Ministry of Health established a Crisis Committee and invited partners to participate in the epidemic response. A WHO-led international response team was set up through the Global Outbreak Alert and Response Network and supplies were channeled through the ICG. Research on the public health implications was carried out by a WHO team in Burkina Faso and other partners to develop an effective surveillance and control strategy for other potential W135 epidemics.