Meningitis- What price will we pay for high vaccine costs?
Jan 25, 2009
MY friend in the Ministry Of Health had tipped me about a pending visit to the meningitis-affected sub- counties of Kigorobya in Hoima and Dadama and Oluko in Arua.
By Irene Nabusoba
MY friend in the Ministry Of Health had tipped me about a pending visit to the meningitis-affected sub- counties of Kigorobya in Hoima and Dadama and Oluko in Arua. “You should come and get a first-hand account,†she says.
Hard to find vaccine
I ponder about the invitation, but the fear of exposure to the deadly disease is overwhelming.
Meningitis is a swelling of the meninges, the lining surrounding the brain and spinal cord. According to the World Health Organisation (WHO), the disease kills about five to 10% of those affected, within 24 to 48 hours, even when it is diagnosed early and treated.
It strikes suddenly and unless drugs are available and used quickly, death rates can soar.
“Are we going to be immunised? How do I minimise the risk?†I ask. “Unfortunately, we have already got our jabs. But they were only for staff, so I advise you to get vaccinated elsewhere,†she says, sending me on a hunting spree for an alternative.
Call me a coward, but I know prevention is better than cure. Besides, if the health officials could get vaccinated, why not me?
I try Mulago Hospital first and the pharmacists refer me to Kampala City Council (KCC) clinics saying, “We sometimes have it, but for staff only. Now we do not.†Neither did the KCC clinics at Naguru and Kawempe.
“Why are you risking travelling to those areas? This vaccine is rare,†the nurse tells me.
High costs
At Kampala International Hospital, I am told that my medical scheme cannot cover the vaccine. It is available, though, at sh50,000. It is almost the same story at African Air Rescue (AAR), although the jab is sh10,000 less.
Health ministry's position
I decide to pin Dr. Nathan Kenya Mugisha, the health ministry’s director of clinical and community services on the high costs of meningitis vaccines.
“We provide this vaccine free to people in affected areas. We are going to vaccinate the people in Arua and Hoima,†he says.
“What about people who want to travel to the affected area for business or otherwise? Is there any way the whole population can benefit?†I interject.
Mugisha regrets that the whole population cannot benefit from the vaccination drive because of financial constraints.
Who gets the vaccine?
“Because of the limited resources, we cannot afford to immunise everybody. The vaccine is very expensive. There is an international coordinating group that controls its availability on the market.
We cannot afford to waste it on unexposed people when many are at high risk. We would run out of stock,†he argues.
Mugisha says the shot is administered once to individuals aged between two to 30 years, on assumption that newborns already have immunity to the disease while those above 30 have probably suffered from it and developed immunity.
It is for these reasons, he says, that the vaccine, which is bought and stored by the Uganda National Expanded Programme for Immunisation, is not readily available. “But there is no cause for alarm. The disease spreads by close contact,†he says.
Last epidemic?
Dr. William Mbabazi, the in-charge of integrated disease surveillance at the WHO, says the disease, which thrives in dry weather, may be occurring in Arua for the last time.
It is a yearly occurrence in Africa’s meningitis belt which stretches from Ethiopia, through central and West Africa.
“I am sure this is the last wave in Arua. It is occurring only in sub-counties where we did not carry out immunisation,†he says.
Nonetheless, I still want to know why the vaccine is not available for whoever wants it.
“Because it is an epidemic-type vaccine,†he explains. “It is not manufactured for routine immunisation. We analyse the epidemic to determine when we should give it and who should get it,†he says.
Hope on the horizon
There is, however, some good news on the horizon. Health ministers from countries in the African meningitis belt last year committed themselves to introducing a more widely available meningitis vaccine.
New, cheaper vaccine coming
The new vaccine for group A meningitis being developed for the Meningitis Vaccine Project (MVP) is a partnership of the WHO and the Programme for Appropriate Technology in Health, an international non-profit organisation.
The project was set up in 2001 with funding from the Bill and Melinda Gates Foundation. It is being produced by the Serum Institute of India and is expected to be licensed this year.
Benefits of the new vaccine
“With this vaccine, countries can move away from a reactive response to emergencies towards elimination of the epidemic threat,†says WHO Director-General, Dr Margaret Chan.
Weakness of current strategy
The WHO, on its website, www.who.org, says over the last 20 years control of epidemic meningitis has emphasised surveillance and mass immunisation.
“Routine immunisation programmes and other public health interventions are suspended as health officials try to respond to the crisis by immunising the populations in areas at risk with the meningococcal polysaccharide vaccine.
However, supplies of this vaccine are limited and the intervention only begins in the last phase of the epidemic with a low effect,†it says.
The global body further argues that this approach, which depends on good surveillance, availability of the vaccine and a properly-functioning health infrastructure, is not the most appropriate for Africa.
How new vaccine will work
The vaccine that the MVP is working on is to be used to control group A meningitis, which accounts for most meningitis epidemics in Africa.
At a cost of $0.40 (about sh800) per dose, WHO says the vaccine produces a higher immune response and provides more long-term protection than the currently available vaccines.
The new meningitis prevention and control strategy entails introducing the new vaccine to immunise a population of approximately 250 million people aged one to 29 and 23 million infants. It will be implemented in 25 African countries between 2009 and 2015.
MY friend in the Ministry Of Health had tipped me about a pending visit to the meningitis-affected sub- counties of Kigorobya in Hoima and Dadama and Oluko in Arua. “You should come and get a first-hand account,†she says.
Hard to find vaccine
I ponder about the invitation, but the fear of exposure to the deadly disease is overwhelming.
Meningitis is a swelling of the meninges, the lining surrounding the brain and spinal cord. According to the World Health Organisation (WHO), the disease kills about five to 10% of those affected, within 24 to 48 hours, even when it is diagnosed early and treated.
It strikes suddenly and unless drugs are available and used quickly, death rates can soar.
“Are we going to be immunised? How do I minimise the risk?†I ask. “Unfortunately, we have already got our jabs. But they were only for staff, so I advise you to get vaccinated elsewhere,†she says, sending me on a hunting spree for an alternative.
Call me a coward, but I know prevention is better than cure. Besides, if the health officials could get vaccinated, why not me?
I try Mulago Hospital first and the pharmacists refer me to Kampala City Council (KCC) clinics saying, “We sometimes have it, but for staff only. Now we do not.†Neither did the KCC clinics at Naguru and Kawempe.
“Why are you risking travelling to those areas? This vaccine is rare,†the nurse tells me.
High costs
At Kampala International Hospital, I am told that my medical scheme cannot cover the vaccine. It is available, though, at sh50,000. It is almost the same story at African Air Rescue (AAR), although the jab is sh10,000 less.
Health ministry's position
I decide to pin Dr. Nathan Kenya Mugisha, the health ministry’s director of clinical and community services on the high costs of meningitis vaccines.
“We provide this vaccine free to people in affected areas. We are going to vaccinate the people in Arua and Hoima,†he says.
“What about people who want to travel to the affected area for business or otherwise? Is there any way the whole population can benefit?†I interject.
Mugisha regrets that the whole population cannot benefit from the vaccination drive because of financial constraints.
Who gets the vaccine?
“Because of the limited resources, we cannot afford to immunise everybody. The vaccine is very expensive. There is an international coordinating group that controls its availability on the market.
We cannot afford to waste it on unexposed people when many are at high risk. We would run out of stock,†he argues.
Mugisha says the shot is administered once to individuals aged between two to 30 years, on assumption that newborns already have immunity to the disease while those above 30 have probably suffered from it and developed immunity.
It is for these reasons, he says, that the vaccine, which is bought and stored by the Uganda National Expanded Programme for Immunisation, is not readily available. “But there is no cause for alarm. The disease spreads by close contact,†he says.
Last epidemic?
Dr. William Mbabazi, the in-charge of integrated disease surveillance at the WHO, says the disease, which thrives in dry weather, may be occurring in Arua for the last time.
It is a yearly occurrence in Africa’s meningitis belt which stretches from Ethiopia, through central and West Africa.
“I am sure this is the last wave in Arua. It is occurring only in sub-counties where we did not carry out immunisation,†he says.
Nonetheless, I still want to know why the vaccine is not available for whoever wants it.
“Because it is an epidemic-type vaccine,†he explains. “It is not manufactured for routine immunisation. We analyse the epidemic to determine when we should give it and who should get it,†he says.
Hope on the horizon
There is, however, some good news on the horizon. Health ministers from countries in the African meningitis belt last year committed themselves to introducing a more widely available meningitis vaccine.
New, cheaper vaccine coming
The new vaccine for group A meningitis being developed for the Meningitis Vaccine Project (MVP) is a partnership of the WHO and the Programme for Appropriate Technology in Health, an international non-profit organisation.
The project was set up in 2001 with funding from the Bill and Melinda Gates Foundation. It is being produced by the Serum Institute of India and is expected to be licensed this year.
Benefits of the new vaccine
“With this vaccine, countries can move away from a reactive response to emergencies towards elimination of the epidemic threat,†says WHO Director-General, Dr Margaret Chan.
Weakness of current strategy
The WHO, on its website, www.who.org, says over the last 20 years control of epidemic meningitis has emphasised surveillance and mass immunisation.
“Routine immunisation programmes and other public health interventions are suspended as health officials try to respond to the crisis by immunising the populations in areas at risk with the meningococcal polysaccharide vaccine.
However, supplies of this vaccine are limited and the intervention only begins in the last phase of the epidemic with a low effect,†it says.
The global body further argues that this approach, which depends on good surveillance, availability of the vaccine and a properly-functioning health infrastructure, is not the most appropriate for Africa.
How new vaccine will work
The vaccine that the MVP is working on is to be used to control group A meningitis, which accounts for most meningitis epidemics in Africa.
At a cost of $0.40 (about sh800) per dose, WHO says the vaccine produces a higher immune response and provides more long-term protection than the currently available vaccines.
The new meningitis prevention and control strategy entails introducing the new vaccine to immunise a population of approximately 250 million people aged one to 29 and 23 million infants. It will be implemented in 25 African countries between 2009 and 2015.