Geneva- Médecins Sans Frontières (MSF) warns that thousands may die of wilful neglect unless a vaccine is made available at an affordable price to the African countries most affected by meningitis. As international experts on meningitis prepare to meet in Burkina Faso next week to discuss strategies to combat the disease, MSF is calling for immediate action by WHO, governments and pharmaceutical companies to avert a potential disaster. Bacterial meningitis is a potentially fatal infection of the brain membrane that kills 25,000 people every year in seasonal epidemics in countries of the African meningitis belt stretching from Senegal to Ethiopia.

A new strain, W135, emerged in Burkina Faso in February-May this year, infecting almost 13,000 people and killing 1,400. There is a great risk that W135 will spread to neighbouring countries during the next epidemic season which could start as soon as November this year.

But the vaccines used in Africa today do not cover the W135 strain. A product that could be used exists in the Western markets, but there is no adequate supply and it is priced beyond the means of African governments and people. "The case of meningitis vaccines speaks volumes about the double standards in health care today", said Dr Bernard Pécoul, Director of MSF's Campaign for Access to Essential Medicines. "There is no vaccine to protect Africans against the new strain during the next epidemic, but tens of thousands of French and British citizens are vaccinated when a few individual cases are detected in these countries.

" Yet, a group of experts convened by MSF has identified feasible strategies to tackle the crisis in Africa. "We can't continue business as usual. What is needed now is an emergency action plan led by WHO and governments to oblige the industry to bring about a quick and affordable solution for African countries for the next epidemic season", Dr Pécoul said.

Two options exist but have not yet been pursued. The first is to make the existing quadrivalent vaccine, with which Western travellers and high risk groups are immunized, available to African countries at a price affordable to them, i.e. at less than $US1 per dose. The best offer so far, by GSK, has been US$3.5, which will bring the total cost of the response needed over the next five years to US$100 million. If the US$1 target price cannot be achieved, MSF calls for the production of a so-called monovalent vaccine, targeted at combating the W135 only, at less than US$0.50.

This vaccine could be used in connection with the existing bivalent (A C) vaccines already in use in Africa. (*) Meningitis is fatal in 50% of untreated cases, and even among patients who receive appropriate diagnosis and treatment, the disease kills 5-10%. 15-20% of the victims also suffer severe neurological damage such as deafness or mental retardation. Mass vaccinations are a vital part of a strategy to keep epidemics at bay.