Epidemic meningitis is a major public health challenge in the African 'meningitis belt', an area that extends from Senegal to Ethiopia with an estimated total population of 500 million. Since 2002, the World Health Organization (WHO), in collaboration with its collaborating centres for meningitis, has progressively supported countries in implementing a strategy of ES for meningitis. The strategy is the recommended standard for all countries of the Belt and it is now actively being implemented at different levels in all countries.