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The East African : Jan 19th 2015
34 The EastAfrican OUTLOOK JANUARY 17-23,2015 S CI E N C E Infants cleared to get Meningitis A vaccine The vaccineac was initially given to those between one and 29 By CHRISTABEL LIGAMI Special Correspondent T he World Health Organisation (WHO) has approved meningitis A vaccine for infants. Priced at 50 cents a dose, Me- nAfriVac will become the most affordable modern vaccine to be scheduled for introduction into routine immunisation programmes by the African governments for children below the age of one. Its approval creates an alter- native route for developing solutions for low-income countries, which suffer the greatest burden of the vaccine-preventable disease. MenAfriVac had been au- thorised by the WHO for use in children and young adults aged between 1 and 29. Peer-reviewed research suggests that in the four years since its introduction in Africa in this older population, MenAfriVac has successfully broken the cycle of meningitis A epidemics. Prequalification by the WHO in children younger than one year is expected to protect millions more children against this deadly disease. WHO’s decision means that the new, 5 mcg (macrogrammes ) dose of the meningitis A vaccine meets international standards of quality, safety, and efficacy and can therefore be administered to children younger than one year of age in Africa. The announcement was made by the Meningitis Vac- THE VACCINE A child getting routine immunisation. Children will now get MenAfriVac as part of routine immunisation. Picture: File cine Project (MVP) — a partnership between the global health Path and WHO — and Serum Institute of India Ltd, which manufactures the MenAfriVac vaccine. In the four years since its in- Now health officials will ensure that protection is sustained by routinely immunising infants.” Marie-Pierre Préziosi, director of the Vaccine Project troduction, MenAfriVac has had an immediate and dramatic impact in breaking the cycle of meningitis A epidemics, leading to the safe, effective technology to be approved by WHO through its prequalification process for use in infants, and paving the way for protecting millions more children at risk of the deadly disease. “Initial mass vaccination cam- paigns with MenAfriVac have been highly effective in reducing the number of meningitis A cases,” said Marie-Pierre Préziosi, director of the Meningitis Vaccine Project. “But epidemics will return when rising numbers of unprotected newborns become a larger proportion of the total population over time. Now, with this decision, health officials will be able to ensure that population-wide protection is sustained by routinely immunising infants.” Before the introduction of Me- nAfriVac, people living in the meningitis belt, which stretches from Senegal in the west to Ethiopia in the east, were regularly struck by meningitis A epidemics in which sudden onset of symptoms could rapidly lead to death or permanent disability. With each epidemic, the dis- ease decimates communities, killing one in ten people and leaving one-quarter of survivors severely debilitated. MenAfriVac, a tailor-made vaccine for Africa, was developed and licensed in record time and introduced n meningitis-belt countries in 2010. Since then, more than 217 million people in 15 countries have received the vaccine. The Meningitis Vaccine Project is a partnership between Path and the World Health Organization. Its mission is to eliminate epidemic meningitis as a public health problem in sub-Saharan Africa through the development, testing, introduction, and widespread use of conjugate meningococcal vaccines. The largest recent outbreak was in 2009 and it involved 14 countries, with more than 88,000 suspected cases and more than 5,000 deaths. One of the most devastat- ing outbreaks ever recorded was in 1996-1997, when an epidemic wave infected more than 250,000 people and killed over 25,000 in just a few months. In 2001, the Bill & Melinda Gates Foundation provided a 10-year grant to establish the Meningitis Vaccine Project to lead the development, testing, licensure, and widespread introduction of a conjugate vaccine to protect millions from group A meningococcal meningitis. This study validates the re- markable success of this effort involving collaborators across four continents. “This is one of the most dramatic outcomes from a public health intervention that I have seen during a long career of research in Africa,” said study author Professor Brian Greenwood, MD, of the London School of Hygiene & Tropical Medicine. Landmark “This landmark study is fur- ther evidence of what a success story this public-private partnership has become in the arena of global health,” said Steve Davis, president and CEO of Path. “When we began this project in 2001, we knew that developing the vaccine was only half the battle. It required intense work to meet rigorous regulatory and technical requirements; to test the vaccine’s safety and efficacy; and to strengthen the countries’ capacity to administer it for the long haul. We are deeply grateful to all the institutions and individuals who have made this vision a reality.” MenAfriVac was developed in record time at less than onetenth the cost of a typical new vaccine. Since campaigns started in 2010, MenAfriVac has been administered to over 210 million people in Africa. D≥ug against loss of hea≥ing f≥om antibiotics he≥e soon By CHRISTABEL LIGAMI Special Correspondent A MODIFIED form of antibiotics meant to minimise hearing loss from use of drugs for bacterial infections like pneumonia is to be tested on humans after researchers got encouraging results from experiments with mice. The new drugs were found to re- duce side effects such as deafness and damage to kidneys. In a study published in the Jour- nal of Clinical Investigation, researchers at the Stanford University School of Medicine said they had managed to produce antibiotics that could not enter the inner ear cells and cause hearing loss. “If we can eventually prevent people from going deaf from taking these antibiotics, in my mind, we will have been successful,” said Anthony Ricci, co-senior author of the study. “Our goal is to replace the existing aminoglycosides with ones that aren’t toxic.” He and his fellow researchers used data from structural biologists at Stanford who better understood how the antibiotics fought off infection. It took the scientists four years of research to produce 5 grammes of the newly patented antibiotic, N1MS, derived from sisomicin, a type of aminoglycoside. N1MS cured urinary tract infec- tion in mice just as well as sisomcicin, but did not cause deafness, study results show. The study presents a promising approach to generating a new class of novel, nontoxic antibiotics, Ricci said. The researchers joined forces in 2007 to explore the idea of creating new and improved versions of these antibiotics based on a simple yet groundbreaking idea born of Prof Ricci’s basic science research into the biophysics of how hearing works within the inner ear. “It’s a nice example of how basic science research is directly translatable into clinical applications,” said Prof Ricci. Because aminoglycosides cause deafness by killing these nonregenerating hair cells, Ricci postulated, why not simply make the drug molecules unable to enter the cells’ 2007 channels? “As a clinician-scientist, I treat kids with hearing loss,” he said. “When a drug causes hearing loss it is devastating, and it’s especially disturbing when this happens to a young child as they rely on hearing to acquire speech. For 20 years, and despite newer, alternative antibiotics, aminoglycosides have remained the mainstay treatment worldwide for many bacterial diseases, including pneumonia, peritonitis and sepsis. They also are often used when other antibiotics have failed to treat infections of unknown origins. Their popularity is due, in part, The year in which researchers started research into these new antibiotics. to their low cost, lack of need for refrigeration and effectiveness at treating bacterial infections at a time when the declining potency of antibiotics is a major public health concern. They are frequently used in neonatal intensive care units to battle infections, or even the threat of infections, which pose a risk for babies. “The toxicity of these drugs is something we accept as a necessary evil,” said Daria Mochly-Rosen, director of Spark, a program at Stanford and one of the researchers For decades, researchers have looked for ways of preventing aminoglycosides from killing off the hearing cells of the inner ear, Prof Ricci said. The goal, Ricci said, was to keep the antibacterial properties of the drug intact while preventing it from entering the inner-ear cell’s ion channels. He and his fellow researchers used data from structural biologists at Stanford who better understood how the antibiotics fought off infection.
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