Meningitis is a deadly and debilitating infectious disease that can be caused by bacteria, viruses, fungi, and parasites. Meningitis affects people of all ages across the globe, but mainly young children. The disease causes an inflammation of the membranes that envelop the brain and spinal cord (meninges), and the symptoms start quickly. Although meningitis can be caused by several microbes, bacterial meningitis is the most dangerous form of the disease. Most bacterial meningitis cases are caused by four pathogens: Neisseria meningitidis (meningococcus), Haemophilus influenzae, Streptococcus pneumoniae (pneumococcus) and Streptococcus agalactiae (Group B Streptococcus, GBS). It is estimated that 1 in 6 people who get bacterial meningitis will die and 1 in 5 people who survive will have long-lasting disabilities like deafness, epilepsy, paralysis, and cognitive impairment. In 2019, bacterial meningitis accounted for 16.3 million disability-adjusted life years (DALYs) and low- and middle-income countries (LMIC) were the most affected regions (>95%). Thus, populations with low socioeconomic status are more likely to die from meningitis or suffer from its long-lasting disabilities.

Although meningitis is considered a global health problem, the highest burden of the disease is found in LMIC, especially the “meningitis belt” of sub-Saharan Africa. The meningitis belt encompasses 26 countries and is known for the high frequency of severe meningitis epidemics reported in the region. Meningitis epidemics have also been reported in other regions, including Latin America and Asia, and demand huge financial resources from the healthcare system to afford patients’ treatment, rehabilitation regimens, and other required control and prevention measures. Considering the economic and social scenario of LMIC, meningitis reinforces and amplifies the inequity that already exists in these countries and highlights the lack of access to health care systems experienced by vulnerable populations.

Safe and effective vaccines to prevent meningitis caused by N. meningitis, H. influenzae, and S. pneumoniae are available, and vaccines against GBS are in advanced development. The meningitis vaccines already available have been successful in decreasing the disease burden, as demonstrated by the eradication of epidemics by Meningococcus serogroup A in the meningitis belt and the reduction in the global meningitis burden due to the implementation of vaccines against H. influenzae type b (Hib) and pneumococcal conjugate vaccines (PCV). These vaccines confer protection not only to the vaccinated people but to the entire population (herd effect) and impact other infectious diseases caused by these pathogens, like pneumonia and sepsis. However, the vaccines against pneumococcus and meningococcus prevent the major but not all serotypes and serogroups able to cause meningitis, and they were not implemented by all LMIC – greatest gaps are observed in middle-income countries. 

Additionally, the reduction rate on the meningitis burden (2000-2019 – meningitis deaths reduced by 39%) was lower than the reduction observed for other vaccine-

preventable diseases (2000-2019 – deaths due to tetanus and measles reduced by 77% and 86%, respectively).

In 2021, the World Health Organization (WHO) together with partners (governments, global health organizations, academia, private sector, among others),

launched a global roadmap to defeat meningitis as a public health threat - DEFEATING MENINGITIS BY 2030 - A GLOBAL ROAD MAP. The roadmap focuses on the four major agents of bacterial meningitis and is based on three visionary goals: to eliminate bacterial meningitis epidemics, reduce cases of vaccine-preventable bacterial meningitis by 50% and deaths by 70%, and reduce disability and improve the quality of life after meningitis due to any cause. These goals will be achieved by integrated actions organized in five pillars, which are prevention and epidemic control, diagnosis and treatment, disease surveillance, care and support, and advocacy and engagement. The global road map is already in course, and it is expected that the achievement of the visionary goals will avert 2,750,000 meningitis cases and 920 000 deaths by 2030. In addition, the global road map will have an impact on reducing the burden of other serious infectious diseases (pneumonia, sepsis), tackling antimicrobial resistance spread, and reducing health-care costs and social inequalities.

The WHO and its partners have taken the lead in the fight against meningitis, but the civil society is also an important ally in this war. It is critical to raise awareness of meningitis and its health and socioeconomic impacts among the global population. The World Meningitis Day, celebrated on October 5th, is a unique moment in the year dedicated to uniting people across the world to fight against meningitis and help save lives. This global movement started in 2009 by a community of people affected by meningitis and is supported by the Confederation of Meningitis Organisations (CoMO) and the Meningitis Research Foundation. The World Meningitis Day involves an active campaign via a dedicated website and social media to share people’s previous experience with meningitis and inform the population across the globe about how to prevent and defeat the disease. Everyone can take action in the campaign and help raise awareness of meningitis by either telling their own story, using the social media toolkit, contacting local politicians, or making a donation. The path towards a world free of meningitis is challenging, but with united action from all sectors (global health organizations, private sector, governments, civil society, academia), we can achieve this ultimate goal and make a lasting impact on global health.

Written by ISID Emerging Leader Laura Oliveira

References

Investing to defeat meningitis and beyond – World Health Organization (WHO)

Defeating meningitis by 2030: a global road map – World Health Organization (WHO)

Introducing World Meningitis Day: 5th October – Meningitis Research Foundation