Title : Towards an african region free of meningitis by 2030: Vision, challenges and priorities
Abstract:
Despite significant progress to combat meningitis over the past 20 years, it remains a major public health challenge in the world. Occurrence of meningitis is greatest in the African “meningitis belt”, an area that extends from Senegal to Ethiopia, with an estimated total population of 500 million in 26 countries.1 Before 2010, Neisseria meningitidis A (N. meningitidis A) was the leading cause of meningitis, accounting for almost 90% of meningitis epidemics.1,2 With the introduction of the MenAfriVac® vaccine since 2010, more than 325 million people aged 9 months to 29 years have been vaccinated in 24 countries of the meningitis belt. This resulted in an overall reduction of meningitis epidemics and a change in the bacterial profile of meningitis, with a predominance of meningococcal C, W, X serogroups, Streptococcus pneumoniae (S. pneumo) and Hemophilus influenzae (Hib).
On August 25, 2021, WHO African Region Member States endorsed the regional framework for implementation of the global roadmap to defeating meningitis by 2030 during the Regional Committee. The vision is to make African region free of meningitis by 2030. The goals are: (i) To eliminate meningitis epidemics, (ii) to reduce cases and deaths from vaccine-preventable bacterial meningitis, and (iii) to reduce disability and improve quality of life after meningitis infection.
Main issues and challenges were found especially (1) Lack of risk assessment model to effectively help predict the occurrence, scale and pathogens that could cause future outbreaks; (2) Insufficient funding in most of the Member States in the African meningitis belt to implement meningitis action plans; (3) Limited access to affected communities because of security challenges and civil strife; (4) Insufficient laboratory capacity; (5) Lack of care for meningitis survivors; and (6) Negative impact of the COVID-19 pandemic on meningitis prevention and control.
To tackle these challenges some priority interventions and actions were identified as follows: on epidemic prevention and control actions are to achieve and maintain high immunization coverage, to introduce effective and affordable new vaccines, including Nm, S. pneumo and Hib, to develop evidence-based policy on Nm, S. pneumo, Hib and GBS vaccination and improve strategies for epidemic prevention and response and to improve diagnosis of meningitis at all levels of care and increase in the timely collection and testing of diagnostic.
To translate this vision into concrete action, these are our priorities: Accelerate key interventions to reduce meningitis epidemics and upgrade meningitis case management and support to reduce sequelae and deaths; Enhance the use of surveillance, data analytics, and evidence to drive progress; Improve country ownership, financing, community and civil society engagement, and partnerships for defeating meningitis; Enhance country ownership, mobilize more financing, strengthen advocacy & partnerships, and program capacities for defeating meningitis.
