Invasive bacterial diseases pose a significant threat to people in countries in the Middle East and North Africa (MENA), many of which lack sufficient public health surveillance and robust access to vaccines. International aid programs are working to improve access to affordable vaccines, but these efforts focus on children. In a recent review of scientific literature, a team from across the Middle East reports that adult vaccination efforts must be prioritized to reduce the burden of preventable diseases, but significant hurdles stand in the way.

Vaccines are already available for the three most common bacterial pathogens behind invasive bacterial diseases — Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae. These three bacteria are associated with deadly diseases such as meningitis, pneumonia, and blood infections. In the modern era, they tend to cause death primarily in aging populations and those with comorbidities. Despite this and the continuing preventable disease burden in adults, few vaccine strategies across the globe prioritize adult populations.

Abdul Rahman Bizri, from the American University of Beirut Medical Center, and a team from Lebanon, Saudi Arabia, United Arab Emirates and Jordan, performed a review of 39 papers found in the biomedical literature database PubMed.

The researchers report that no countries within the MENA region currently have routine adult [invasive meningococcal disease] vaccination policies. Vaccination policies for high-risk individuals are in place in some countries, such as Saudi Arabia, where many Hajj pilgrims are required to have meningococcal vaccinations. However, the introduction of comprehensive adult vaccination strategies across the region is significantly hindered by the lack of access to affordable vaccines.

There is also a “disappointing” lack of epidemiological data or public health surveillance on vaccines, say the researchers. This surveillance is important to identify new pathogen strains, as well as for implementing and evaluating prophylaxis or treatment strategies.

The researchers say it is crucial that the lack of adult vaccination programs is addressed. This would not only addresses the burden of preventable diseases in adults, but also the critical issue of antimicrobial resistance, since disease prevention would reduce antimicrobial use.

The researchers make several recommendations in their review, such as implementing surveillance mandates, using electronic medical records, and putting knowledge and information management systems in place. In addition, they highlight the value of training medical personnel effectively regarding the importance of surveillance. Through commitments from and cooperation between governments, the private sector, and international organizations, the researchers argue, preventative disease levels in the MENA region can be reduced significantly.

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