21 December 2012 vol 338, issue 6114, pages 1497-1676
The United States is currently in the midst of a meningitis outbreak (with at least 36 deaths) as the result of fungal contamination of steroid injections to relieve back pain (1). In Africa’s so-called “meningitis belt,” outbreaks of meningitis are a regular occurrence, killing thousands and infecting tens of thousands each year. In 2009, about 5300 people died of meningitis and 88,000 were infected with the disease (2). The meningitis belt stretches from Senegal in the West to Ethiopia in the East and includes around 300 million people. Sanofi Pasteur had provided Africa with a meningitis vaccine for decades but because of reduced supplies in 2006 and 2007, and a threat of increased incidences of the disease, the World Health Organization (WHO) made a call for additional vaccine providers (3). But it wasn’t multinational companies from wealthy nations that responded, but two Latin American countries that answered the call. What brought Brazil and Cuba together in this seemingly unlikely collaboration?