MenAfriVac is a vaccine developed for use in sub-Saharan Africa for children and adults between 9 months and 29 years of age against meningococcal bacterium Neisseria meningitidis group A. The vaccine costs less than US$0.50 per dose. History Epidemics of meningococcal A meningitis, which is a bacterial infection of the thin lining surrounding the brain and spinal cord, have swept across 26 countries in sub-Saharan Africa for a century, killing and disabling young people every year. The disease is highly feared on the continent; it can kill or cause severe brain damage in a child within hours. Epidemics usually start at the beginning of the calendar year when dry sands from the Sahara Desert begin blowing southward. The largest meningitis epidemic in African history swept across sub-Saharan Africa from 1996 to 1997, numbering 250,000 new cases and taking 25,000 lives. Three years later, the World Health Organization (WHO) held a technical consultation in Cairo, Egypt with African ministers of health and global health leaders to discuss meningitis and the development of a new vaccine. At that meeting, representatives from eight African countries issued a statement saying that the development of a meningococcal vaccine to prevent epidemics was a high priority for them, and concluded that a conjugate meningococcal vaccine would have the potential to prevent future epidemics. They estimated that the new vaccine could become available in three to seven years for US$0.40 to $1 a dose, providing protection for at least ten years. A year later, in 2001, the Bill & Melinda Gates Foundation provided a ten-year, $70 million grant to establish the Meningitis Vaccine Project, a partnership between PATH and WHO. The foundation charged the new project with development, testing, licensure and mass introduction of a meningococcal conjugate vaccine. In 2002, the collaboration supported reinforced meningitis surveillance activities in 12 countries in Africa: Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Côte d'Ivoire, Ethiopia, Ghana, Mali, Niger, Nigeria and Togo. The surveillance indicated an increased risk of outbreaks in the future and the continued need for a vaccine. MenAfriVac became available for widespread use in African meningitis belt countries in 2010. Distribution in Mali and Niger was assisted by Médecins Sans Frontières. Effectiveness evaluation A 2013 article published in The Lancet reported that the MenAfriVac vaccination campaign in Chad reduced meningitis incidence by 94%. In three regions of Chad, approximately 1.8 million people from 1 to 29 years