- Elimination of miningitis in Africa shadowed by COVID-19 pandemic - 50 Million children miss vaccination

The World Health Organisation (WHO) and partners have launched a roadmap aimed at stopping bacterial meningitis by 2030, and urge countries to implement it rapidly before the start of the meningitis season in January 2023.

This follows the COVID-19 pandemic's outcomes of delaying meningitis vaccination campaigns for more than 50 million children in Africa. The region is said to be at a heightened risk of outbreaks of meningitis type A, which has nearly been eliminated on the continent.

WHO Africa Regional Director Matshidiso Moeti says the defeat of meningitis type A is one of Africa’s biggest success stories in health, but the fallout from COVID-19 hampers their drive to eliminate this bacterial infection as a public health threat once and for all and could lead to catastrophic resurgences.

“In prioritising the response to COVID-19, we must not lose our focus on other health problems. I urge countries to ramp up implementation of the new WHO regional roadmap now before the meningitis season begins in January 2023,” Dr. Moeti says.

The pandemic severely disrupted meningitis prevention and control services, with disease surveillance, laboratory confirmation of cases, and outbreak investigations all steeply declining.

Reports from countries indicate that meningitis control activities were reduced by 50 percent in 2020 compared with 2019 with a slight improvement in 2021.

Benin, Guinea, Guinea Bissau, Nigeria, and Togo delayed campaigns with the MenAfriVac vaccine aimed at protecting a total of 50 million children under 12 years of age against meningitis type A.

Public Relations officer at the Ministry of Health and Wellness, Dr. Christopher Nyanga says that the COVID-19 pandemic has affected all facets of the health system in Botswana and elsewhere across the world. He however says that the declining cases should ameliorate the condition.

"Declining cases of COVID-19, therefore give us an opportunity to focus on all conditions including meningitis. Since the introduction of the Pneumococcal vaccine in 2012, Botswana has not recorded any case of Pneumococcal meningitis," he says, noting that at the moment, the Ministry ensures that relevant attention is given to the condition.

Historically, meningitis type A was the highest cause of meningitis outbreaks in Africa. In 2010, however, Africa embarked on a journey to defeat meningitis type A when an effective vaccine, MenAfriVac, was developed and deployed.

The vaccine was developed in response to a plea from African health ministers after a meningitis type A outbreak in 1996 infected more than 250 000 people and killed over 25 000 in just a few months.

With WHO and partners’ support, more than 350 million people in 24 high-risk African countries have received the MenAfriVac vaccine since 2010.

While no meningitis type A case has been reported in Africa during the past five years, outbreaks still occur and are caused by other types of meningococcal bacteria. Dr Moeti says that the continent is still at risk.

"More than 400 million Africans are still at risk of seasonal meningitis outbreaks, but the disease has remained off the radar for too long,” she said.

In 2019, 140 552 people in the African region died from all types of meningitis. Major outbreaks caused by meningitis type C have been recorded in seven meningitis belt countries since 2013.

In 2021, a four-month outbreak in the Democratic Republic of the Congo claimed 205 lives.

Moreover, the African region accounts for the highest number of new meningitis cases globally and is the only region to still experience outbreaks. The continent reports 100 cases of meningitis cases per 100 000 people, the highest incidence in the world.

Dr. Moeti adds that besides the toll on human life, outbreaks negatively impact health systems, and fragile economies, and impoverish entire populations as they are forced to contend with multiple health and socio-economic challenges.

"In an ambitious bid to defeat bacterial meningitis in the African region by 2030, the new regional strategy launched sets out a roadmap for countries to shore up diagnosis, surveillance, care, advocacy, and vaccination to eliminate outbreaks, curb deaths by 70 percent and halve infections," Dr. Moeti adds.

WHO estimates that an amount o US$1.5 billion will be required between now and 2030 to implement the plan which if countries fully adopt it, will save more than 140 000 lives every year in the region and significantly reduce disability.

In Africa, the meningitis season is particularly long, stretching from January to June. Although meningitis affects all ages, young children are most at risk, with around half of cases and deaths occurring in children under five.

Dr. Nyanga tells Botswana Guardian that his ministry tries by all means to fight the condition, including availing the necessary medications in the event that a child gets affected.