Only a few giant corporations on the planet—companies like Merck, GlaxoSmithKline, and Sanofi-Aventis—are thought to have the money, the know-how, and the infrastructure to develop new vaccines that can make a really big impact on public health.
So when a little nonprofit from Seattle called PATH is able to band together with some officials at the World Health Organization to develop a new vaccine against a deadly bug in Africa that the big guys weren’t interested in—that’s what we in the journalism business call a story. This is about going on a long and risky journey, persevering against long odds, to do something potentially really important.
This week, PATH has been featured in the New York Times, the Seattle Times, and on the KPLU website for its work in developing a new vaccine for meningitis, called MenAfriVac. On Monday, people across Burkina Faso, Mali, and Niger started getting their shots to protect them against this seasonal bug. I got a very absorbing perspective on this odyssey by talking with PATH president Chris Elias a couple weeks ago. He talked about what it takes to develop a vaccine that can protect people from this bacterial infection, at a cost of just 50 cents a dose. Much heavy lifting has been done, and much more is come, as the goal is to give this vaccine to at least 12 million kids and young adults this month.
The origins of the story trace back to 1996-97, when a particularly deadly outbreak of bacterial meningitis struck in sub-Saharan countries of Africa, Elias says. About 250,000 people got infected in the meningitis belt from Senegal to Sudan that season, and about one out of every 10 people died. Meningitis bacteria is spread from person to person via sneezing and coughing, and typically is at its worst during the hot, windy season that helps the bug spread across African countries until seasonal rains tamp it down, Elias says. Antibiotics are effective against the bacteria, but typically need to be given in the first couple days of the epidemic, because it can kill that quickly. Since these nations are among the world’s poorest, they don’t have enough public health infrastructure to effectively treat everyone in an outbreak, Elias says.
Around those same years of the late 1990s, a different kind of meningitis outbreak was happening in the United Kingdom. People in the UK were getting sick with a seasonal strain of what’s known as meningitis C. Given this was causing problems in a wealthy country, four companies stepped in to fill the void, developing vaccines specifically for meningitis C. These companies figured out how to take a marker on the meningitis bacteria (an antigen) and covalently attach it to a protein that would serve like a red flag for the immune system, provoking it to fight against the bacteria. This new conjugated vaccine was essentially able to eliminate the meningitis C bug from the UK. Importantly, it got the people at PATH thinking hard about whether this lesson could be applied to meningitis A, the bug that causes 85 percent of the illness in Africa. Big Pharma had at least some experience and interest in this field, as evidenced with Pfizer’s multi-billion dollar pneumococcal vaccine (Prevnar).
“When we started this project, we knew the technical risks of developing a vaccine were actually pretty low,” Elias says. “It’s not like malaria, where we are still trying to break the code.”
Suddenly, the economics of developing a vaccine singularly designed for meningitis A started looking more feasible for a nonprofit. PATH put together
