In the African meningitis belt, epidemics of meningococcal disease occur periodically, although unpredictably, every few years. These epidemics continue to cause havoc but new efforts to control the disease, through the use of conjugate vaccines, are being made.
Universal vaccination became part of government policy in 1978. A quarter of a century since, progress has been fitful. In some parts of the country the south especially progress has been impressive, but in two of the most populous states Bihar and