Fifteen percent of the $30 million earmarked by Pfizer for healthcare development in Kano will be spent on the administrators of the fund. So says the chairman of the trust fund. Speaking in an interaction with newsmen shortly after the second meeting of the trustees of the Pfizer/Kano State Healthcare Programme Trust Fund, the chairman Professor Shehu Galadanci disclosed that his committee, which is charged with supervising construction of befitting healthcare facilities in the state, has a $30 million allocation.
What will the money be spent on? The chairman disclosed that the 15 percent, which translates to $4.5 million, will be used to provide temporary office accommodation for the trustees, provide accommodation for committee members who come for meetings from outside Kano, pay remuneration of consultants and take care of incidental expenses.
He also disclosed that the committee was set to start working on building brand new comprehensive healthcare facility once land is allocated for the purpose.
Observers are however worried that the whopping sum of $4.5 million is too high, too exorbitant for catering to the comfort of committee members. “It is a case of spending too much money on hospitality instead of the hospital”, said Mallam Hadi Usman Ado, a pharmacist. Perhaps the committee is still in the teething stages and the amount earmarked will be reviewed downwards. Otherwise members of the trust fund committee will be hard put explaining why they should not be described as freeloaders.
Saturday, October 10, 2009
Thursday, October 8, 2009
Pfizer's Trovan Settlement Demands Irk Nigerian Kleptocrats
Ref: http://industry.bnet.com/pharma/10002202/pfizers-demand-for-trovan-funds-transparency-irks-nigerian-kleptocrats/
Pfizer is emerging as an unexpected champion of the poor against Nigeria’s kleptocracy as it negotiates a $75 million settlement in the Trovan case.
Back story: The case stems from tests Pfizer did in 1996 during a meningitis outbreak in the African nation. Eleven children died. Trovan’s use was restricted in the US and banned in Europe.
One of the major sticking points holding up the final settlement (aside from this U.S. judge) is how to distribute the money to victims in such a way that it does not find its way into the hands of Nigeria’s notoriously corrupt politicians. Nigeria ranks 121st out of 180 countries in terms of corruption (No. 180 — Somalia — being the most corrupt).
The AP noted recently:
… two matters remained to be resolved: How to ensure settlement funds reached their intended victims and that the funds disbursement was done with full accountability.
This Day added:
[Governor Ibrahim Shekarau] said a committee of trustees involving various stakeholders had been set up to verify the victims and the veracity of their impairment to ensure that justice is done in the sharing of the compensation.
Nigerian lawyers will, of course, make out like bandits. About $10 million of the settlement is earmarked for them, according to AllAfrica.com columnist Aliyu Asad. Of the rest:
35 million to the test patients and 30 million towards some form of development of health infrastructure.
That “infrastructure” could take the form of a hospital, which would take years to build, according to Shekarau.
Asad notes that Pfizer’s insistence on making sure that victims actually benefit from the settlement is making Nigeria’s elite increasingly uncomfortable:
The powerful have much to gain from this windfall especially with elections only a couple of years away.
Whilst Kano State government are calling for self determination in managing the disbursal of the settlement funds; It is interesting to note that all statements from the Pfizer camp declare that it is their wish transparency and due process be observed in distribution of funds.
Many in Kano States ruling elite may be wishing that settlement had occurred earlier when the eyes of the world were not so sharpened to corrupt practices of large global corporations, but after scandals such as Enron, KBR and Siemens, the world is watching Nigeria and global companies carefully. It would be corporate suicide for a company like Pfizer to just write a blank cheque and walk away.
Jim Edwards, a former managing editor of Adweek, has covered drug marketing at Brandweek for four years, and is a former Knight-Bagehot fellow at Columbia University's business and journalism school
Ref: http://industry.bnet.com/pharma/10002202/pfizers-demand-for-trovan-funds-transparency-irks-nigerian-kleptocrats/
Pfizer is emerging as an unexpected champion of the poor against Nigeria’s kleptocracy as it negotiates a $75 million settlement in the Trovan case.
Back story: The case stems from tests Pfizer did in 1996 during a meningitis outbreak in the African nation. Eleven children died. Trovan’s use was restricted in the US and banned in Europe.
One of the major sticking points holding up the final settlement (aside from this U.S. judge) is how to distribute the money to victims in such a way that it does not find its way into the hands of Nigeria’s notoriously corrupt politicians. Nigeria ranks 121st out of 180 countries in terms of corruption (No. 180 — Somalia — being the most corrupt).
The AP noted recently:
… two matters remained to be resolved: How to ensure settlement funds reached their intended victims and that the funds disbursement was done with full accountability.
This Day added:
[Governor Ibrahim Shekarau] said a committee of trustees involving various stakeholders had been set up to verify the victims and the veracity of their impairment to ensure that justice is done in the sharing of the compensation.
Nigerian lawyers will, of course, make out like bandits. About $10 million of the settlement is earmarked for them, according to AllAfrica.com columnist Aliyu Asad. Of the rest:
35 million to the test patients and 30 million towards some form of development of health infrastructure.
That “infrastructure” could take the form of a hospital, which would take years to build, according to Shekarau.
Asad notes that Pfizer’s insistence on making sure that victims actually benefit from the settlement is making Nigeria’s elite increasingly uncomfortable:
The powerful have much to gain from this windfall especially with elections only a couple of years away.
Whilst Kano State government are calling for self determination in managing the disbursal of the settlement funds; It is interesting to note that all statements from the Pfizer camp declare that it is their wish transparency and due process be observed in distribution of funds.
Many in Kano States ruling elite may be wishing that settlement had occurred earlier when the eyes of the world were not so sharpened to corrupt practices of large global corporations, but after scandals such as Enron, KBR and Siemens, the world is watching Nigeria and global companies carefully. It would be corporate suicide for a company like Pfizer to just write a blank cheque and walk away.
Jim Edwards, a former managing editor of Adweek, has covered drug marketing at Brandweek for four years, and is a former Knight-Bagehot fellow at Columbia University's business and journalism school
Thursday, August 13, 2009
Mens Sana Congratulates Kano and Pfizer
Press Release
Statement released by Mens Sana Wednesday, 12th August 2009:
The health-sector Non-Governmental Organisation, MENS SANA, has congratulated both the Kano State Government and pharmaceutical giants Pfizer on their recent out-of-court settlement mutually endorsed last week. In a statement signed by its National Coordinator, Hajiya Muslima A. Kadi, the organization said the settlement would achieve the following: (1) Financial relief for the patients and their families; (2) Upgrade of facilities and general rehabilitation of the Infectious Diseases Hospital in Kano; (3) Improved training programmes for health personnel and (4) Capacity building to enable the state better cope with epidemics of meningitis in future.
The organization is impressed with the caliber of people nominated to serve on the Board of Trustees of the two Committees for the Healthcare/Meningitis Fund and Healthcare Initiatives respectively. According to MENS SANA, “It is hoped that the Board will be alive to its responsibilities and prevent fraud either in the process of disbursement of funds to participants or in the award of contracts for projects”.
Continuing, the statement said, “We want to caution the members not to allow their venerable names to be soiled by desperate fraudsters who are lurking around the corner with various schemes. Experience has shown us in this country in the past that assembling a galaxy of men of timbre alone is not enough insurance against misappropriation.”
The NGO therefore vowed to maintain vigilance over the entire process and urged all other civil society groups to do the same. “Having come thus far, we cannot afford to leave the whole process in the hands of the Boards alone. It is our collective responsibility to ensure that for once maximum good is derived from the Pfizer funds whose timing can be deemed providential. Convinced that the challenge of achieving this noble goal has only just begun, we shall deploy our personnel and resources to continually monitor the activities and decisions of the Boards in the interest of the larger society”, said the statement.
Applauding the fatherly role of the Emir of Kano Alhaji Ado Bayero and the level-headedness of Governor Shekarau, the statement specially commended General Yakubu Gowon for working tirelessly to bring both parties together to reach an amicable settlement. The press release further applauded Pfizer for living up to its billing as a responsible corporate citizen.
Statement released by Mens Sana Wednesday, 12th August 2009:
The health-sector Non-Governmental Organisation, MENS SANA, has congratulated both the Kano State Government and pharmaceutical giants Pfizer on their recent out-of-court settlement mutually endorsed last week. In a statement signed by its National Coordinator, Hajiya Muslima A. Kadi, the organization said the settlement would achieve the following: (1) Financial relief for the patients and their families; (2) Upgrade of facilities and general rehabilitation of the Infectious Diseases Hospital in Kano; (3) Improved training programmes for health personnel and (4) Capacity building to enable the state better cope with epidemics of meningitis in future.
The organization is impressed with the caliber of people nominated to serve on the Board of Trustees of the two Committees for the Healthcare/Meningitis Fund and Healthcare Initiatives respectively. According to MENS SANA, “It is hoped that the Board will be alive to its responsibilities and prevent fraud either in the process of disbursement of funds to participants or in the award of contracts for projects”.
Continuing, the statement said, “We want to caution the members not to allow their venerable names to be soiled by desperate fraudsters who are lurking around the corner with various schemes. Experience has shown us in this country in the past that assembling a galaxy of men of timbre alone is not enough insurance against misappropriation.”
The NGO therefore vowed to maintain vigilance over the entire process and urged all other civil society groups to do the same. “Having come thus far, we cannot afford to leave the whole process in the hands of the Boards alone. It is our collective responsibility to ensure that for once maximum good is derived from the Pfizer funds whose timing can be deemed providential. Convinced that the challenge of achieving this noble goal has only just begun, we shall deploy our personnel and resources to continually monitor the activities and decisions of the Boards in the interest of the larger society”, said the statement.
Applauding the fatherly role of the Emir of Kano Alhaji Ado Bayero and the level-headedness of Governor Shekarau, the statement specially commended General Yakubu Gowon for working tirelessly to bring both parties together to reach an amicable settlement. The press release further applauded Pfizer for living up to its billing as a responsible corporate citizen.
Thursday, July 30, 2009
Kano and Pfizer Finally Settle
The lingering Trovan saga between Kano State of Nigeria and pharmaceutical giants Pfizer came to an amicable end last on 30th July 2009 when the agreement to settle all the contending issues out of court was jointly signed by representatives of both parties in the presence of former Nigerian Head of State, General Yakubu Gowon.
In a joint statement released at the ensuing press conference, the parties said, “We are pleased to announce that we have reached a final agreement to settle the Trovan litigation between Pfizer and the Kano State government. The parties agree that settlement is in the best interest of both parties, as it avoids the cost and distraction of protracted litigation and enables both of us to focus on our core missions and business.”
In financial terms, the total settlement is worth $75 million. The terms are that Pfizer would (1) establish a Healthcare/Meningitis Trust Fund of up to US$35 million from which study participants can receive financial support; (2) underwrite several healthcare initiatives chosen by the Kano State government that benefit the people of Kano State, totaling US$30 million over a period of time; and (3) reimburse Kano State for US$10 million in legal costs associated with the litigation.
Both parties have empanelled two independent Board of Trustees to administer and oversee the disbursement of funds with the following membership:
Healthcare/Meningitis Trust Fund:
Hon. Justice (Rtd.) S.M.A. Belgore
Bala Borodo, M.D.
Professor Isa Hashim
Muuta Ibrahim, M.D.
Prosper Ikechukwu Igboeli, M.D.
Hon. Justice (Rtd.) Abubakar Bashir Wali
Healthcare Related Programs Trust Fund:
Professor Shehu Galadanchi
Ibrahim A. Haruna
Adamu Jafiya
Adamu Aliyu Kiyawa
Habibu Sadauki, M.D.
Professor Auwalu Yadudu
It is noteworthy that the settlement is based on no admission of liability by Pfizer because so far no offence has been established against the pharmaceutical company in spite of several years of litigation. Also, Kano State will withdraw both the civil and criminal Trovan-related cases it filed against the company and various individuals.
In a separate statement, Pfizer’s Senior Vice President and Associate General Counsel Brad Lerman said, “We have been a partner with the people and governments of Nigeria for more than 50 years. The company believes that a mutually agreeable resolution to the Trovan cases is the best way to continue that relationship and allow Pfizer and the Nigerian governments to focus on what matters - improving healthcare for all Nigerians.”
It is expected that the settlement will also lead to the withdrawal of the cases filed by the federal government in respect of the same Trovan trials of 1996. Answering a question at the press conference, General Yakubu Gowon who helped midwife the truce said the federal authorities gave him the impression that once Kano State had reached an agreement with Pfizer, the federal cases would subsequently be withdrawn.
It will be recalled that the cerebrospinal meningitis epidemic that struck Nigeria in 1996 took at least 12,000 lives over a six-month period, and affected more than 100,000 people.
.
In a joint statement released at the ensuing press conference, the parties said, “We are pleased to announce that we have reached a final agreement to settle the Trovan litigation between Pfizer and the Kano State government. The parties agree that settlement is in the best interest of both parties, as it avoids the cost and distraction of protracted litigation and enables both of us to focus on our core missions and business.”
In financial terms, the total settlement is worth $75 million. The terms are that Pfizer would (1) establish a Healthcare/Meningitis Trust Fund of up to US$35 million from which study participants can receive financial support; (2) underwrite several healthcare initiatives chosen by the Kano State government that benefit the people of Kano State, totaling US$30 million over a period of time; and (3) reimburse Kano State for US$10 million in legal costs associated with the litigation.
Both parties have empanelled two independent Board of Trustees to administer and oversee the disbursement of funds with the following membership:
Healthcare/Meningitis Trust Fund:
Hon. Justice (Rtd.) S.M.A. Belgore
Bala Borodo, M.D.
Professor Isa Hashim
Muuta Ibrahim, M.D.
Prosper Ikechukwu Igboeli, M.D.
Hon. Justice (Rtd.) Abubakar Bashir Wali
Healthcare Related Programs Trust Fund:
Professor Shehu Galadanchi
Ibrahim A. Haruna
Adamu Jafiya
Adamu Aliyu Kiyawa
Habibu Sadauki, M.D.
Professor Auwalu Yadudu
It is noteworthy that the settlement is based on no admission of liability by Pfizer because so far no offence has been established against the pharmaceutical company in spite of several years of litigation. Also, Kano State will withdraw both the civil and criminal Trovan-related cases it filed against the company and various individuals.
In a separate statement, Pfizer’s Senior Vice President and Associate General Counsel Brad Lerman said, “We have been a partner with the people and governments of Nigeria for more than 50 years. The company believes that a mutually agreeable resolution to the Trovan cases is the best way to continue that relationship and allow Pfizer and the Nigerian governments to focus on what matters - improving healthcare for all Nigerians.”
It is expected that the settlement will also lead to the withdrawal of the cases filed by the federal government in respect of the same Trovan trials of 1996. Answering a question at the press conference, General Yakubu Gowon who helped midwife the truce said the federal authorities gave him the impression that once Kano State had reached an agreement with Pfizer, the federal cases would subsequently be withdrawn.
It will be recalled that the cerebrospinal meningitis epidemic that struck Nigeria in 1996 took at least 12,000 lives over a six-month period, and affected more than 100,000 people.
.
Thursday, July 23, 2009
Making Political Capital Out Of Pfizer Settlement
Making Political Capital Out Of Pfizer Settlement
By
Musa Sani Yanusa
(musayanusa@gmail.com)
It is interesting how the handlers of Governor Shekarau’s image have been trying to make political capital out of the on-going settlement talks regarding the 1996 test of Pfizer’s drug, Trovan. The rumour in town is that the Kano State governor, not being eligible for re-election as governor after his second four-year term which expires in 2011, is casting his sights at the plum job of president of the federal republic. Structures are reportedly being put in place to facilitate the realization of this dream. No one can begrudge the governor his tall ambition. Has anyone ever devised a way of keeping the ant away from the sugar lick?
What rankles is the attempt to cash in on the current settlement talks to portray the governor as the sole malaika who has brought the chestnut out of the fire. To make the governor’s lionization look truly gargantuan, the claim is made by Sule Yau Sule, his director of media, in a syndicated article that 200 patients died in the trials. This is a typical devise used by desperate propagandists to create a storm in a tea cup. How could 200 people have died in a programme that had a total of 200 participants with 94 percent survival rate? Of course Mr. Sule was aware that only 11 people died on the whole – five from the Trovan group and six from those on the gold standard treatment. The 200 patients had been divided into two groups of 100 each, that is half on Trovan and the other half on the standard treatment. What the trials actually showed was that some of the patients were too far gone in the stage of the meningitis affliction that it was too late to help them. We can all recall that more than 12,000 other victims of the disease who did not have early access to medical help died in the epidemic.
The contentious points in the litigation would have been fully thrashed out in a full blown trial if the court cases had run their full course. But all those sympathetic to the cause of the participants felt that a long litigation was not a guarantee for success. What if the case was lost at the end of the day? That was why everyone concerned - civil society groups, lawyers, the federal and Kano State governments, Pfizer, the Trovan trial participants and public commentators all worked towards an amicable settlement. It is therefore ill-advised to attempt conducting a media trial of a case being settled out of court. It is equally immoral to distort facts and pronounce judgement on issues that would have been argued in court in a full trial.
But Nigerian politics is nothing if not inventively disingenuous. The quest for higher office is now being serviced with a mish-mash of untruths and crafty innuendos with the hope that our penchant for collective amnesia will seal the sleight of hand with a stamp of veracity. Mind you, I am not against the aspirations of Governor Shekarau. My attitude to the dour gentleman and many of his second-term colleagues in other states is that if they truly won the elections that returned them into office, then they must have been doing some things right in the eyes of their people.
The political landscape in the country now is replete with various manholes, bumps, booby traps and even landmines. Only Nigerian politicians have the required dare devilry to venture into the fray. The stakes in 2011 will be high for the simple reason that the people are fed up with the incompetence of successive governments. There is so much despondency in the land. The national currency, the naira, has been on a free fall for some time. While the dollar and the pound sterling are falling against other currencies, they are appreciating in Nigeria – which shows how bad our situation is. President Yar’ Adua’s seven-point agenda is good on paper but in terms of delivery it is something else. If a popularity poll is conducted today, the president’s rating will not be flattering, and that is putting it mildly. But that is not to say that the president has been idle. It is just an indication that so far his best is not enough.
To my knowledge, Shekarau has not achieved the kind of magic performed by the likes of Donald Duke in Cross River State or Babatunde Fasola in Lagos. If I had a say in the matter, I would advise the governor to try and beat the record of Audu Bako, the builder of modern Kano. It was Audu Bako that transformed Kano from a semi-urban trading town to a sprawling modern city. Today, people mention that name with reverence and a silent prayer for the repose of his people-friendly soul.
I don’t know if General Buhari still plans to run for the presidency in 2011 after the treachery of his party (ANPP’s) leadership in the last two years. If Buhari intends to run, can Shekarau beat him in a free and fair party primary? Buhari is not known to have a fat war chest (that is if he has any chest at all), but he is perceived as a man with plenty of integrity. Those who have had dealings with him, either when he was military head of state or after he was rudely shoved out of power, say that he is incorruptible. His only well advertised problem is his stubbornness.
Some analysts have however been calling for new faces and a reversal of the trend where certain people become known as professional presidential candidates in a country of 140 million people. There is merit in that call. America broke with its past of well articulated deceit and veiled racism and gave the world Barack Obama. The slogan was “Yes we can”. And yes, they did! With our can-do spirit, I have no doubt that Nigerians too can rise above our present state of pedestrian perambulation and rise to the challenge of nationhood by producing elected leaders that would be the envy of the rest of the free world.
The next general elections are two years away but already governance has stopped in many states as the incumbent governors struggle to get second term tickets. Alignments and realignments are going on all over the place. Some governors have already crossed over from their party to the ruling PDP (what a price to pay for marrying the president’s daughter!) How is the interest of the people served in all these moves? It is as if the goal of politics is self-serving power; power at all costs; power for the sake of power.
But watch out for the banana peels. The graveyard of Nigerian politics is full of the bones of erstwhile strutting political bulls who learnt too late the same lesson the moth learnt from the flame. By all means, let all aspiring players come out, but let no one insult our intelligence. I have nothing against Shekarau’s candidacy. He is yet to announce his intention to run for president but already the grapevine is buzzing with the news. Maybe if he achieves the status of a present day Audu Bako I might even campaign for him. But I would be doing so with my two eyes wide open, not based on the false lionization; not based on a puerile distortion of facts.
By
Musa Sani Yanusa
(musayanusa@gmail.com)
It is interesting how the handlers of Governor Shekarau’s image have been trying to make political capital out of the on-going settlement talks regarding the 1996 test of Pfizer’s drug, Trovan. The rumour in town is that the Kano State governor, not being eligible for re-election as governor after his second four-year term which expires in 2011, is casting his sights at the plum job of president of the federal republic. Structures are reportedly being put in place to facilitate the realization of this dream. No one can begrudge the governor his tall ambition. Has anyone ever devised a way of keeping the ant away from the sugar lick?
What rankles is the attempt to cash in on the current settlement talks to portray the governor as the sole malaika who has brought the chestnut out of the fire. To make the governor’s lionization look truly gargantuan, the claim is made by Sule Yau Sule, his director of media, in a syndicated article that 200 patients died in the trials. This is a typical devise used by desperate propagandists to create a storm in a tea cup. How could 200 people have died in a programme that had a total of 200 participants with 94 percent survival rate? Of course Mr. Sule was aware that only 11 people died on the whole – five from the Trovan group and six from those on the gold standard treatment. The 200 patients had been divided into two groups of 100 each, that is half on Trovan and the other half on the standard treatment. What the trials actually showed was that some of the patients were too far gone in the stage of the meningitis affliction that it was too late to help them. We can all recall that more than 12,000 other victims of the disease who did not have early access to medical help died in the epidemic.
The contentious points in the litigation would have been fully thrashed out in a full blown trial if the court cases had run their full course. But all those sympathetic to the cause of the participants felt that a long litigation was not a guarantee for success. What if the case was lost at the end of the day? That was why everyone concerned - civil society groups, lawyers, the federal and Kano State governments, Pfizer, the Trovan trial participants and public commentators all worked towards an amicable settlement. It is therefore ill-advised to attempt conducting a media trial of a case being settled out of court. It is equally immoral to distort facts and pronounce judgement on issues that would have been argued in court in a full trial.
But Nigerian politics is nothing if not inventively disingenuous. The quest for higher office is now being serviced with a mish-mash of untruths and crafty innuendos with the hope that our penchant for collective amnesia will seal the sleight of hand with a stamp of veracity. Mind you, I am not against the aspirations of Governor Shekarau. My attitude to the dour gentleman and many of his second-term colleagues in other states is that if they truly won the elections that returned them into office, then they must have been doing some things right in the eyes of their people.
The political landscape in the country now is replete with various manholes, bumps, booby traps and even landmines. Only Nigerian politicians have the required dare devilry to venture into the fray. The stakes in 2011 will be high for the simple reason that the people are fed up with the incompetence of successive governments. There is so much despondency in the land. The national currency, the naira, has been on a free fall for some time. While the dollar and the pound sterling are falling against other currencies, they are appreciating in Nigeria – which shows how bad our situation is. President Yar’ Adua’s seven-point agenda is good on paper but in terms of delivery it is something else. If a popularity poll is conducted today, the president’s rating will not be flattering, and that is putting it mildly. But that is not to say that the president has been idle. It is just an indication that so far his best is not enough.
To my knowledge, Shekarau has not achieved the kind of magic performed by the likes of Donald Duke in Cross River State or Babatunde Fasola in Lagos. If I had a say in the matter, I would advise the governor to try and beat the record of Audu Bako, the builder of modern Kano. It was Audu Bako that transformed Kano from a semi-urban trading town to a sprawling modern city. Today, people mention that name with reverence and a silent prayer for the repose of his people-friendly soul.
I don’t know if General Buhari still plans to run for the presidency in 2011 after the treachery of his party (ANPP’s) leadership in the last two years. If Buhari intends to run, can Shekarau beat him in a free and fair party primary? Buhari is not known to have a fat war chest (that is if he has any chest at all), but he is perceived as a man with plenty of integrity. Those who have had dealings with him, either when he was military head of state or after he was rudely shoved out of power, say that he is incorruptible. His only well advertised problem is his stubbornness.
Some analysts have however been calling for new faces and a reversal of the trend where certain people become known as professional presidential candidates in a country of 140 million people. There is merit in that call. America broke with its past of well articulated deceit and veiled racism and gave the world Barack Obama. The slogan was “Yes we can”. And yes, they did! With our can-do spirit, I have no doubt that Nigerians too can rise above our present state of pedestrian perambulation and rise to the challenge of nationhood by producing elected leaders that would be the envy of the rest of the free world.
The next general elections are two years away but already governance has stopped in many states as the incumbent governors struggle to get second term tickets. Alignments and realignments are going on all over the place. Some governors have already crossed over from their party to the ruling PDP (what a price to pay for marrying the president’s daughter!) How is the interest of the people served in all these moves? It is as if the goal of politics is self-serving power; power at all costs; power for the sake of power.
But watch out for the banana peels. The graveyard of Nigerian politics is full of the bones of erstwhile strutting political bulls who learnt too late the same lesson the moth learnt from the flame. By all means, let all aspiring players come out, but let no one insult our intelligence. I have nothing against Shekarau’s candidacy. He is yet to announce his intention to run for president but already the grapevine is buzzing with the news. Maybe if he achieves the status of a present day Audu Bako I might even campaign for him. But I would be doing so with my two eyes wide open, not based on the false lionization; not based on a puerile distortion of facts.
Friday, May 8, 2009
Trovan Settlement: Stop Spreading Mischief
Trovan Settlement: Stop Spreading Mischief
By
Yau Zurumi
(yauzuru@gmail.com)
Laborious as reading the article, “Kano Pfizer Victims’ Compensation and Saboteur Writers” on gamji.com turned out to be, I managed to decipher the fact that its writer, Isa Muhammad Inuwa, is one of “grand patron” Maisikeli’s ‘consultants’. I forgive his grammatical inadequacies seeing that he has signed off as a correspondent of Radio Deutsche Welle. I take it that he reports for the Hausa service and therefore does not have to pass the standard test applied to the English medium journalists he tried to rubbish. I don’t know what any normal person can have against the clamour to ensure that those who participated in the Trovan trials are not shortchanged.
Unless a person has criminal intent it is difficult to understand the opposition to transparency in the disbursement of funds. I have written several articles on the settlement issue and I am glad that we are seeing light at the end of the tunnel. Many well meaning people are delighted by the positive turn of events in the settlement talks. But insha Allah, none of the professional money-snatchers struggling for recognition will get their hands on money meant for the patients or the funds for the rehabilitation of healthcare facilities in Kano.
The attempt to demonize anyone who calls for transparency is an old but cheap trick used by people without cerebral endowments. It is easier for them to reduce the issue to their gutter level where things would be muddied. But facts are sacred and comments free. Even if Isa Mohammad Inuwa derives his daily bread from the loot in Maisikeli’s custody, that is no licence for libeling decent people. The attack on Doctors Isa Dutse and Sanda Muhammad is quite irresponsible. Inuwa also finds it expedient to pour insults on newspaper columnists who have called for a transparent process; respected public commentators like Abbah Mahmoud and Sanusi Abubakar are called unflattering names simply because they insist that the settlement funds should not be treated the same way we treat public funds – sharing them among members of an inner circle.
No commentator has ever said anything against the settlement talks. All they have insisted is that no matter how big the sum is, the families of the patients should directly receive the money after due verification. Who but a crooked schemer could be against such a honest piece of advice? It is worthy of note that one of the problems of the writer is that he mixes up his local fight with two journalists in Kano with the comments of other journalists outside the city. It is best to leave their local fight to them at their level of operation because to comment further on that will not dignify this piece.
Obviously the writer Inuwa is operating from a position of blissful ignorance. People like him and Maisikeli have been misleading Kano people about the facts of the case in court. People like us who have seen through all the lies have cautioned our people not to fall for the cheap attempt to railroad them into a fight they can’t finish because the defence filed in court clearly contradicts all the propaganda being churned out by Maisikeli and his gang of gold-diggers. It is on record, and any interested person with the appropriate intellectual tools can access the records in court. Pfizer was permitted to carry out the trials by the federal and Kano State governments. Also, NAFDAC gave them a written permission. What then is all this talk about sneaking into Nigeria? There were nurses on hand who interpreted what was going on in Hausa language to the patients and their guardians. And then what were the results? Pfizer had a higher survival rate than “Doctors Without Borders” who also operated side by side with Pfizer. These facts are incontrovertible and I would advise Inuwa and his paymasters to get a copy of the relevant documents from the honourable Attorney-General of Kano.
Perhaps one should ask Inuwa if he knows something about the misinformation slotted into the German journal, Der Spiegel which carried a photograph of one Anas Mohammed and described him as a Trovan victim. It turned out that Anas was never placed on Trovan but on the gold standard drug and that he did not suffer hearing and vocal disabilities as claimed by the desperate informants of the German news medium. I read Der Spiegel’s retraction of the story and their apology to the reading public for the misinformation. Without doubt, a ‘patriotic’ busybody like Inuwa must have been behind the falsehood.
As I have said, I am not aware of any NGO that wants to take over the sharing of the settlement funds. The so-called Trovan Victims’ Forum is the only unregistered body seeking to profit from the settlement. I must not fail to highlight the innuendo contained in the said write-up to the effect that Abuja and southern newspapers were conspiring against the Trovan Victims’ Forum. That puerile assertion can only come from a demented mind incapable of sustaining an argument without bringing in religion and ethnicity. It is just like when a stupid person from the South-South insists that a Northerner has no right to comment on the militancy and kidnapping going on in their creeks.
I am a full blooded and proud Northern Muslim. I am on the side of truth. I make bold to swear that I have no intention nor do I have the link to profit from the settlement funds. All I want is for the patients to get their rightful dues and for the healthcare funds to be applied transparently. May anyone who intends to steal from the poor patients be decisively dealt with by Almighty Allah Himself. As we are not doing this discourse in Hausa but in English, I want to conclude with the English translation (Abdullah Yusufali) of the greatest book of revelation, the Holy Quran, Surah 101:
The Calamity, The Stunning Blow, The Disaster
1. The (Day) of Noise and Clamour:
2. What is the (Day) of Noise and Clamour?
3. And what will explain to thee what the (Day) of Noise and Clamour is?
4. (It is) a Day whereon men will be like moths scattered about,
5. And the mountains will be like carded wool.
6. Then, he whose balance (of good deeds) will be (found) heavy,
7. Will be in a life of good pleasure and satisfaction.
8. But he whose balance (of good deeds) will be (found) light,-
9. Will have his home in a (bottomless) Pit.
10. And what will explain to thee what this is?
11. (It is) a Fire Blazing fiercely!
By
Yau Zurumi
(yauzuru@gmail.com)
Laborious as reading the article, “Kano Pfizer Victims’ Compensation and Saboteur Writers” on gamji.com turned out to be, I managed to decipher the fact that its writer, Isa Muhammad Inuwa, is one of “grand patron” Maisikeli’s ‘consultants’. I forgive his grammatical inadequacies seeing that he has signed off as a correspondent of Radio Deutsche Welle. I take it that he reports for the Hausa service and therefore does not have to pass the standard test applied to the English medium journalists he tried to rubbish. I don’t know what any normal person can have against the clamour to ensure that those who participated in the Trovan trials are not shortchanged.
Unless a person has criminal intent it is difficult to understand the opposition to transparency in the disbursement of funds. I have written several articles on the settlement issue and I am glad that we are seeing light at the end of the tunnel. Many well meaning people are delighted by the positive turn of events in the settlement talks. But insha Allah, none of the professional money-snatchers struggling for recognition will get their hands on money meant for the patients or the funds for the rehabilitation of healthcare facilities in Kano.
The attempt to demonize anyone who calls for transparency is an old but cheap trick used by people without cerebral endowments. It is easier for them to reduce the issue to their gutter level where things would be muddied. But facts are sacred and comments free. Even if Isa Mohammad Inuwa derives his daily bread from the loot in Maisikeli’s custody, that is no licence for libeling decent people. The attack on Doctors Isa Dutse and Sanda Muhammad is quite irresponsible. Inuwa also finds it expedient to pour insults on newspaper columnists who have called for a transparent process; respected public commentators like Abbah Mahmoud and Sanusi Abubakar are called unflattering names simply because they insist that the settlement funds should not be treated the same way we treat public funds – sharing them among members of an inner circle.
No commentator has ever said anything against the settlement talks. All they have insisted is that no matter how big the sum is, the families of the patients should directly receive the money after due verification. Who but a crooked schemer could be against such a honest piece of advice? It is worthy of note that one of the problems of the writer is that he mixes up his local fight with two journalists in Kano with the comments of other journalists outside the city. It is best to leave their local fight to them at their level of operation because to comment further on that will not dignify this piece.
Obviously the writer Inuwa is operating from a position of blissful ignorance. People like him and Maisikeli have been misleading Kano people about the facts of the case in court. People like us who have seen through all the lies have cautioned our people not to fall for the cheap attempt to railroad them into a fight they can’t finish because the defence filed in court clearly contradicts all the propaganda being churned out by Maisikeli and his gang of gold-diggers. It is on record, and any interested person with the appropriate intellectual tools can access the records in court. Pfizer was permitted to carry out the trials by the federal and Kano State governments. Also, NAFDAC gave them a written permission. What then is all this talk about sneaking into Nigeria? There were nurses on hand who interpreted what was going on in Hausa language to the patients and their guardians. And then what were the results? Pfizer had a higher survival rate than “Doctors Without Borders” who also operated side by side with Pfizer. These facts are incontrovertible and I would advise Inuwa and his paymasters to get a copy of the relevant documents from the honourable Attorney-General of Kano.
Perhaps one should ask Inuwa if he knows something about the misinformation slotted into the German journal, Der Spiegel which carried a photograph of one Anas Mohammed and described him as a Trovan victim. It turned out that Anas was never placed on Trovan but on the gold standard drug and that he did not suffer hearing and vocal disabilities as claimed by the desperate informants of the German news medium. I read Der Spiegel’s retraction of the story and their apology to the reading public for the misinformation. Without doubt, a ‘patriotic’ busybody like Inuwa must have been behind the falsehood.
As I have said, I am not aware of any NGO that wants to take over the sharing of the settlement funds. The so-called Trovan Victims’ Forum is the only unregistered body seeking to profit from the settlement. I must not fail to highlight the innuendo contained in the said write-up to the effect that Abuja and southern newspapers were conspiring against the Trovan Victims’ Forum. That puerile assertion can only come from a demented mind incapable of sustaining an argument without bringing in religion and ethnicity. It is just like when a stupid person from the South-South insists that a Northerner has no right to comment on the militancy and kidnapping going on in their creeks.
I am a full blooded and proud Northern Muslim. I am on the side of truth. I make bold to swear that I have no intention nor do I have the link to profit from the settlement funds. All I want is for the patients to get their rightful dues and for the healthcare funds to be applied transparently. May anyone who intends to steal from the poor patients be decisively dealt with by Almighty Allah Himself. As we are not doing this discourse in Hausa but in English, I want to conclude with the English translation (Abdullah Yusufali) of the greatest book of revelation, the Holy Quran, Surah 101:
The Calamity, The Stunning Blow, The Disaster
1. The (Day) of Noise and Clamour:
2. What is the (Day) of Noise and Clamour?
3. And what will explain to thee what the (Day) of Noise and Clamour is?
4. (It is) a Day whereon men will be like moths scattered about,
5. And the mountains will be like carded wool.
6. Then, he whose balance (of good deeds) will be (found) heavy,
7. Will be in a life of good pleasure and satisfaction.
8. But he whose balance (of good deeds) will be (found) light,-
9. Will have his home in a (bottomless) Pit.
10. And what will explain to thee what this is?
11. (It is) a Fire Blazing fiercely!
Friday, April 3, 2009
Pfizer and Kano Settling out of court at last
Some good news is coming out of Kano at last. Away from the gory details we have been having in the recent past about how meningitis has been ravaging the state and neighboring states (the death toll at the last count was officially over 1,000 – even with all the under-reporting involved), the news from the ancient merchant city now is that the state government and Pfizer are now about to reach a final settlement with regard to the Trovan case.
It is 13 years since Pfizer embarked on the trials during a terrible meningitis epidemic in Kano. It is now generally known from court papers that the pharmaceutical company did not sneak into Nigeria to administer lethal drugs on the populace as alleged but that the whole exercise had all the necessary approvals of the relevant consenting authorities. It is no longer debatable, too, that Pfizer helped save lives – a fact confirmed by the thousands of deaths this year which show that the disease is the culprit not the company.
So far, the legal tangle has been more of motion without movement and it is doubtful that if the cases were to be pursued to their logical conclusion, the government and the people would walk away smiling. Analysts have therefore been upbeat about the fact that the settlement talks are at last yielding dividends.
Although Pfizer is keeping sealed lips as to the full details of the settlement, journalists have been able to learn from sources close to the government that a total sum of $75 million will be spent by Pfizer in funding various items on the negotiation menu. It was gathered that the company will provide some funds for the patients who participated in the study (or their next of kin where appropriate). But due diligence will be strictly applied every step of the way.
Modalities for verification are being worked out and only those certified to have participated in the study will benefit from the fund, providing also that those with medically proven disabilities from the meningitis affliction will get higher sums than those not so affected. It will be interesting to see how the final list of beneficiaries will be arrived at, considering the fact that the 13-year-old documents required in the case may not be all available.
However, close watchers, especially civil society groups, agree that strict verification has to be carried out. They point to the recent disclosures in the newspapers that fake ‘Trovan victim lists’ have been in circulation in Kano. Many of those on the list, it was revealed, were born crippled but were smuggled into the fake lists to defraud the settlement process. It was in view of this kind of development that Pfizer is said to have insisted right from the onset that everything has to be transparent because that was the only way the funds could get to their intended destination. It is no longer considered prophetic to say that if the rules are not stiff and clear, most of the funds will end up in private bank accounts as has happened in other cases in the country.
Pfizer is also said to be interested in funding the rehabilitation of the Infectious Diseases Hospital (IDH) in Kano, the building of a pediatric wing in the facility and capacity building for the medical personnel to enable them cope with possible epidemics in future. The only credible way to actualize these noble objectives is to ensure that the funds are administered by a neutral body comprising men and women of integrity, possibly an international non-governmental organization, NGO, with representatives of the Kano State Government, civil society and Pfizer itself.
If diligently implemented, the Pfizer Fund can change the face of healthcare in Kano forever. The grapevine has it that $30 million is earmarked for the development fund. In local currency, that is N5.1 Billion – more than the budget provision for healthcare in Kano State for the whole of 2009! Such a hefty sum must not be handled carelessly because of the quantum of good it can do in the lives of the people of Kano.
It is expected that the Kano State Government will support Pfizer’s insistence on due process and transparency in the implementation of all the fine details of the agreement. There cannot be ghost beneficiaries, nor can there be phantom projects that will never see the light of day. As rightly noted by a non-governmental organization, Mens Sana, this settlement provides a great opportunity to retool the IDH in Kano and change the lives of the beneficiaries and the generality of Kano people for good.
The greed of a few individuals to hijack the funds cannot be allowed to scuttle a God-sent opportunity to put this sorry saga behind us and face the future with hope and determination to confront coming challenges with courage.
Feelers from the Kano State Government appear positive, going by the reported reaction of the Attorney-General Aliyu Umar, on BBC’s Hausa service: "They promised not to disclose the amounts involved until they sit down and negotiate how to implement the agreement."
Pfizer’s spokesman, Chris Loder, said in a statement issued in New York shortly after news of the ‘settlement details’ hit the airwaves, “While progress has been made in conversations with the Kano State government, there is no agreement at this time. Indeed, several critical issues remain unresolved regarding key procedures to prevent any misappropriation of funds. The parties must also agree on specific health initiatives to ensure the benefits of the settlement are transparent and realized. Pfizer’s intention is to bring the Trovan matter to a fair and final resolution and we are committed to remaining at the negotiating table until that is accomplished.”
So close and yet so far? Whatever happens henceforward, it is our hope and prayer that the Trovan patients and the people of Kano who will benefit from the other Pfizer initiatives will not be swindled out of their entitlements.
It is 13 years since Pfizer embarked on the trials during a terrible meningitis epidemic in Kano. It is now generally known from court papers that the pharmaceutical company did not sneak into Nigeria to administer lethal drugs on the populace as alleged but that the whole exercise had all the necessary approvals of the relevant consenting authorities. It is no longer debatable, too, that Pfizer helped save lives – a fact confirmed by the thousands of deaths this year which show that the disease is the culprit not the company.
So far, the legal tangle has been more of motion without movement and it is doubtful that if the cases were to be pursued to their logical conclusion, the government and the people would walk away smiling. Analysts have therefore been upbeat about the fact that the settlement talks are at last yielding dividends.
Although Pfizer is keeping sealed lips as to the full details of the settlement, journalists have been able to learn from sources close to the government that a total sum of $75 million will be spent by Pfizer in funding various items on the negotiation menu. It was gathered that the company will provide some funds for the patients who participated in the study (or their next of kin where appropriate). But due diligence will be strictly applied every step of the way.
Modalities for verification are being worked out and only those certified to have participated in the study will benefit from the fund, providing also that those with medically proven disabilities from the meningitis affliction will get higher sums than those not so affected. It will be interesting to see how the final list of beneficiaries will be arrived at, considering the fact that the 13-year-old documents required in the case may not be all available.
However, close watchers, especially civil society groups, agree that strict verification has to be carried out. They point to the recent disclosures in the newspapers that fake ‘Trovan victim lists’ have been in circulation in Kano. Many of those on the list, it was revealed, were born crippled but were smuggled into the fake lists to defraud the settlement process. It was in view of this kind of development that Pfizer is said to have insisted right from the onset that everything has to be transparent because that was the only way the funds could get to their intended destination. It is no longer considered prophetic to say that if the rules are not stiff and clear, most of the funds will end up in private bank accounts as has happened in other cases in the country.
Pfizer is also said to be interested in funding the rehabilitation of the Infectious Diseases Hospital (IDH) in Kano, the building of a pediatric wing in the facility and capacity building for the medical personnel to enable them cope with possible epidemics in future. The only credible way to actualize these noble objectives is to ensure that the funds are administered by a neutral body comprising men and women of integrity, possibly an international non-governmental organization, NGO, with representatives of the Kano State Government, civil society and Pfizer itself.
If diligently implemented, the Pfizer Fund can change the face of healthcare in Kano forever. The grapevine has it that $30 million is earmarked for the development fund. In local currency, that is N5.1 Billion – more than the budget provision for healthcare in Kano State for the whole of 2009! Such a hefty sum must not be handled carelessly because of the quantum of good it can do in the lives of the people of Kano.
It is expected that the Kano State Government will support Pfizer’s insistence on due process and transparency in the implementation of all the fine details of the agreement. There cannot be ghost beneficiaries, nor can there be phantom projects that will never see the light of day. As rightly noted by a non-governmental organization, Mens Sana, this settlement provides a great opportunity to retool the IDH in Kano and change the lives of the beneficiaries and the generality of Kano people for good.
The greed of a few individuals to hijack the funds cannot be allowed to scuttle a God-sent opportunity to put this sorry saga behind us and face the future with hope and determination to confront coming challenges with courage.
Feelers from the Kano State Government appear positive, going by the reported reaction of the Attorney-General Aliyu Umar, on BBC’s Hausa service: "They promised not to disclose the amounts involved until they sit down and negotiate how to implement the agreement."
Pfizer’s spokesman, Chris Loder, said in a statement issued in New York shortly after news of the ‘settlement details’ hit the airwaves, “While progress has been made in conversations with the Kano State government, there is no agreement at this time. Indeed, several critical issues remain unresolved regarding key procedures to prevent any misappropriation of funds. The parties must also agree on specific health initiatives to ensure the benefits of the settlement are transparent and realized. Pfizer’s intention is to bring the Trovan matter to a fair and final resolution and we are committed to remaining at the negotiating table until that is accomplished.”
So close and yet so far? Whatever happens henceforward, it is our hope and prayer that the Trovan patients and the people of Kano who will benefit from the other Pfizer initiatives will not be swindled out of their entitlements.
Monday, March 2, 2009
Centers for Disease Control and Prevention
CDC Health Information for International Travel 2008
Prevention of Specific Infectious Diseases
Meningococcal Disease
CDC Health Information for International Travel 2008
Prevention of Specific Infectious Diseases
Meningococcal Disease
Description
Meningococcal disease is an acute bacterial infection characterized by sudden onset with fever, intense headache, nausea, vomiting, stiff neck, and, frequently, a rash with pink macules that develops petechiae (1). Formerly, the case-fatality ratio exceeded 50%, but early diagnosis, modern therapy, and supportive measures have lowered the case-fatality ratio to about 10% in developed countries. Among survivors, 11%-19% have long-term sequelae, including hearing loss, neurologic disability, or limb loss (2). Up to 10% of populations in countries with endemic disease carry Neisseria meningitidis asymptomatically in the nose and throat (3).
Meningococci are classified into serogroups based on the composition of the capsular polysaccharide. Five major meningococcal serogroups associated with disease are A, B, C, Y and W-135 (3). In the past 30 years, meningococci serogroups B and C have been responsible for most disease in the Americas and Europe (3,4). Serogroup A meningococci and, to a lesser extent, serogroup C, account for most meningococcal disease cases in Africa and some areas in Asia. During the past years, serogroup Y has emerged as a cause of disease in Northern America, and serogroup W-135 has been associated with meningococcal disease epidemics in Saudi Arabia and Burkina Faso (5-7).
Occurrence
Sporadic cases and outbreaks of meningococcal disease occur throughout the world. In the sub-Saharan African “meningitis belt,” which extends from Mali to Ethiopia, peaks of serogroup A meningococcal disease occur regularly during the dry season (December through June) (8). In addition, major epidemics occur every 8-12 years (see Map 4-10). In 2000, a serogroup W-135 epidemic occurred in Saudi Arabia in association with the Hajj pilgrimage (6). Cases among returning pilgrims and their families occurred in a number of countries, including several cases in the United States. In 2002, a major meningococcal disease epidemic occurred in Burkina Faso caused by serogroup W-135 (7). Since 2002, serogroup W-135 has been detected in several African countries, but it has not caused major epidemics.
Risk for Travelers
Travelers to sub-Saharan Africa may be at risk for meningococcal disease. Travelers to the meningitis belt during the dry season should be advised to receive meningococcal vaccine, especially if they will have prolonged contact with local populations. Prompted by a serogroup A meningococcal disease outbreak associated with the 1987 Hajj, Saudi Arabia requires that Hajj and Umrah visitors have a certificate of vaccination with a tetravalent (A,C,Y,W-135) meningococcal vaccine before entering.
Clinical Presentation
Sudden onset of fever, intense headache, neck stiffness, nausea, and often vomiting are common signs and symptoms of meningococcal sepsis, with or without meningitis, in persons over the age of 2 years. These symptoms can develop over several hours, or they may take 1-2 days. Other symptoms may include photophobia and an altered mental status. In infants, a slower onset of signs and symptoms may occur with nonspecific symptoms, and neck stiffness may be absent.
Early diagnosis and treatment are critical. If symptoms occur, the patient should seek medical care immediately. The diagnosis is usually made by growing bacteria collected from cerebrospinal fluid (CSF), detection of the meningococcal antigen through latex agglutination in fresh CSF, or evidence of N. meningitidis DNA by polymerase chain reaction (1). N. meningitidis can also be identified in blood cultures. The signs and symptoms of meningococcal meningitis are similar to those of other causes of bacterial meningitis, such as Haemophilus influenzae and Streptococcus pneumoniae. Identification of the type of bacteria responsible is important for selection of correct antibiotics. Answers to frequently asked questions about meningitis can be found at the following website: http://www.cdc.gov/ncidod/dbmd/diseaseinfo.
Prevention
In January 2005, a tetravalent meningococcal polysaccharide-protein conjugate vaccine (MCV4) was licensed for use among persons aged 11-55 years. In October 2007, MCV4 vaccine was approved for use in children aged 2-10 years (11). Tetravalent meningococcal polysaccharide vaccine (MPSV4) is also available in the United States. Both vaccines protect against meningococcal disease caused by serogroups A, C, Y, and W-135 (Table 4-13). However, MCV4 is expected to be efficacious in young children, confer long-term protection, and provide herd immunity by reducing nasopharyngeal carriage and transmission. CDC’s Advisory Committee on Immunization Practices (ACIP) recommends vaccination with MCV4 at the earliest opportunity for persons aged 11-18 years and for college freshmen living in dormitories (2, 12). Vaccination is also recommended for persons who have certain medical conditions that place them at increased risk of meningococcal disease, particularly deficiencies in the terminal common complement pathway (C3, C5-9) and anatomic or functional asplenia.
The ACIP recommends vaccination against meningococcal disease to persons who travel to or reside in countries in which N. meningitidis is hyperendemic or epidemic, particularly if contact with the local population will be prolonged. MCV4 is preferred among persons aged 2-55 years. MPSV4 is the recommended vaccine among persons aged >55 years; MPSV4 is also an acceptable alternative for persons aged 2-55 years (2, 11).
Vaccination against meningococcal disease is not a requirement for travel to any country except Saudi Arabia, where travelers to Mecca during the annual Hajj and Umrah pilgrimage must have proof of vaccination. Vaccination is recommended for persons traveling to the meningitis belt in Africa during the dry season, December through June. Advisories for travelers to other countries will be issued when epidemics of meningococcal disease caused by vaccine-preventable serogroups are recognized (see the CDC Travelers’ Health website at http://wwwn.cdc.gov/travel).
For both MCV4 and MPSV4, approximately 7-10 days are required following vaccination for development of protective levels of anti-meningococcal antibodies. In general, use of MPSV4 should be restricted to persons at least 2 years of age; however, children as young as 3 months of age may be vaccinated to elicit short-term protection against serogroup A meningococcal disease. No vaccine is currently available in the United States to offer protection against serogroup B.
Serogroup C polysaccharide conjugate vaccines have been used in infants and children in Europe and Canada. Studies from the United Kingdom (UK) have reported that these vaccines are safe and immunogenic in infants and children and can decrease transmission, thus protecting unvaccinated individuals by inducing herd immunity (9).
Antibiotic chemoprophylaxis among close contacts of a patient with meningococcal disease is recommended for prevention of secondary cases in the United States and most industrialized countries. Antimicrobial regimens for prophylaxis include rifampin, ciprofloxacin or ceftriaxone, although rifampin is not recommended for pregnant women (1). Antimicrobial chemoprophylaxis should be considered for airline passengers who have had direct contact with respiratory secretions from the index patient, and for passengers seated directly next to the index patient on prolonged flights (>8 hours) (http://wwwn.cdc.gov/travel/contentMenin.aspx). A study in 2001 among U.S. Hajj pilgrims found that pathogenic meningococcal nasopharyngeal carriage was uncommon in this vaccinated population; CDC does not currently recommend antimicrobial chemoprophylaxis or cultures to determine carriage for returning pilgrims (6).
ADVERSE REACTIONS
Adverse reactions to both MCV4 and MPSV4 are usually mild, consisting principally of localized erythema that lasts 1-2 days. Among adolescents aged 11-18 years, pain and limited movement at the injection site were more common with MCV4 than MPSV4. Low-grade fever occurs in a small percentage of persons who receive MCV4 and MPSV4 (2).
PRECAUTIONS AND CONTRAINDICATIONS
Vaccination with MCV4 and MPSV4 is contraindicated among persons known to have a severe allergic reaction to any component of the vaccine, including diphtheria toxoid (for MCV4), or to dry natural rubber latex (2). Studies of MCV4 in pregnant women have not been done. Studies of MPSV4 during pregnancy have not documented adverse events among either women or neonates (1 month of age or younger) (2). Persons with a history of Guillain-Barré syndrome (GBS) might be at increased risk for GBS after MCV4 vaccination; therefore, a history of GBS is a precaution to administering MCV4. For children with a history of GBS, MPSV4 is an acceptable alternative for short-term (i.e., 3--5 years) protection against meningococcal disease (11). (Section updated February 15, 2008)
(Section Updated February 15, 2008)
Treatment
Meningococcal disease is potentially fatal and should always be viewed as a medical emergency. Admission to a hospital or health center is necessary. Antibiotic treatment must be started early in the course of the disease (in patients with meningitis, lumbar puncture should be done before starting antibiotics if possible to ensure the bacteria will grow in culture). On presentation the appropriate antibiotics for treatment are dictated by the differential diagnosis; once the diagnosis is confirmed, several antibiotic choices are available, and an infectious disease consultant can be asked to assist in management (1).
References
1. LK American Academy of Pediatrics. Meningococcal infections. In: Pickering LK, editor. Red book: 2003 Report of the Committee on Infectious Disease. 26th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2003. p. 430-6.
2. CDC. Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2005;54(RR-7):1-21.
3. Raghunathan PL, Bernhardt SA, Rosenstein NE. Opportunities for Control of Meningococcal Disease in the United States. Ann Rev Med. 2004;55:333-53.
4. Rosenstein NE, Perkins BA, Stephens DS, Lefkowitz L, Cartter ML, Danila R, et al. The changing epidemiology of meningococcal disease in the United States, 1992-1996. J Infect Dis. 1999;180: 1894-901.
5. Rosenstein NE, Perkins BA, Stephens DS, et al. Meningococcal disease. N Engl J Med. 2001;344:1378-88.
6. Dull P, Abdelwahab J, Sacchi CT, Becker M, Noble CA, Barnett GA, et al. Serogroup W-135 Neisseria meningitidis carriage among US travelers to the 2001 Hajj. J Infect Dis. 2005;191:33-9.
7. Raghunathan PL, Jones JD, Tiendrebeogo SR, Sanou I, Sangare L, Kouanda S, et al. Predictors of immunity after a major serogroup W-135 meningococcal disease epidemic, Burkina Faso, 2002. J Infect Dis. 2006;193:607-16.
8. Greenwood B. Meningococcal meningitis in Africa. Trans R Soc Trop Med Hyg. 1999;93:341-53.
9. Maiden MC, Stuart JM; UK Meningococcal Carriage Group. Carriage of serogroup C meningococci 1 year after meningococcal C conjugate polysaccharide vaccine. Lancet. 2002;359:1829-31.
10. CDC. Update: Guillain-Barré Syndrome among recipients of Menactra meningococcal conjugate vaccine—United States, October 2005-February 2006. MMWR Morbid Mortal Wkly Rep. 2006;55: 364-6.
11. CDC. Notice to Readers: Recommendation from the Advisory Committee on Immunization Practices (ACIP) for Use of Quadrivalent Meningococcal Conjugate Vaccine (MCV4) in Children Aged 2-10 Years at Increased Risk for Invasive Meningococcal Disease. MMWR 2007;56(48):1265-1266.
12. CDC. Notice to Readers: Revised Recommendations of the Advisory Committee on Immunization Practices to Vaccinate All Persons Aged 11-18 Years with Meningococcal Conjugate Vaccine. MMWR 2007;56(31):794-795.
AMANDA COHN, KRISTIN UHDE, NANCY MESSONNIER
MAP 4-10 Areas with frequent epidemics of meningococcal meningitis.
TABLE 4-13. Meningococcal vaccines
TYPE OF VACCINE
DOSE
COMMENTS
Tetravalent A, C, Y, W- 135, conjugated to diphtheria toxoid for intramuscular injection (MCV4)
0.5 mL
Licensed for persons aged 2-55 years. Duration of immunity expected to be longer than the polysaccharide vaccine.
Tetravalent A, C, Y, W- 135, for subcutaneous injection (MPSV4)
0.5 mL
Duration of immunity is unknown, but appears to be at least 5 years in those ≥4 years of age. Revaccination after 2-3 years should be considered for children first vaccinated at <4 years of age who continue to be at high risk
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