Via The New York Times: Amid Failure and Chaos, an Ebola Vaccine. Excerpt:
Ebola lingers. A 15-year-old boy in Monrovia, Liberia, his father and his brother are sick with the disease, the first cases in Liberia since June. How the boy caught Ebola is a mystery, but it is likely he had contact with an Ebola survivor. The virus also lingers in the body — and can sicken its host and infect others — even months after recovery.
There will most likely be more cases in this epidemic. But now, greater awareness and new tools are in place to contain them better, including a tool we have never had before: an effective vaccine.
Last year, Ebola became an international crisis that killed 11,300 people because of a failure of political will, according to a new report from Harvard and the London School of Hygiene and Tropical Medicine. Countries with the outbreak played down the initial cases and delayed reporting the outbreak to the World Health Organization until March 2014, three months after it began. The international response was unconscionably late. The W.H.O. did not declare an emergency until August, and only in September did large-scale international help reach the scene.
But since then, one thing has moved with record speed. In October 2014, researchers began Phase 1 safety trials of potential Ebola vaccines. By late March, one of them was saving lives in Guinea. A process that normally takes years had been compressed into six months.
The Ebola vaccine is a double achievement. Researchers proved the effectiveness not just of a novel vaccine, but also of a novel method of testing it rapidly, in chaotic conditions and without traditional clinical trials. Even as it was being tested, the vaccine was helping to contain Ebola. Today, hopes are high that it will administer the coup de grace to the epidemic.
How was this achieved? And what can the world learn that will save lives and money in fighting future outbreaks of Ebola or other pathogens?
Ebola is a fearsome virus — but not to vaccine researchers. Making an Ebola vaccine has proved to be straightforward. By the time of the outbreak, in fact, several vaccine candidates had already been tested in animals and been found safe and effective. That had happened because of the very fear the disease inspires — paradoxically not in Africa, but in North America.
“None of these vaccines were designed to protect Africans during an outbreak,” said Adrian Hill, director of the Jenner Institute, a vaccine research group at the University of Oxford. “Their development was all funded to protect North Americans against bioterrorists using the Ebola virus.”
Animal testing is the easy part; what’s hard is moving beyond it. Vaccine development requires lots of money and attention, and the cruel fact is that both are always scarce for poor-country diseases. That is even more true for pathogens that begin with small outbreaks in remote areas. Vaccines may be needed only at some future day, in tiny quantities — or, hopefully, not at all.
“Everybody realizes there is no market for the industry,” said Marie-Paule Kieny, assistant director-general of the World Health Organization for Health Systems and Innovation. “You can’t just rely on the private sector to invest — there is no revenue for them. You need a coalition of the willing — philanthropists, but this is mainly the responsibility of governments.”
Outbreak pathogens include Ebola; Severe Acute Respiratory Syndrome, which caused 774 deaths 12 years ago; and its cousin, Middle East Respiratory Syndrome. They hold the world’s attention while they rage — and then are quickly forgotten. “There were many vaccines in development for SARS, and after it ended they all stopped,” said David Heymann, head of the Center on Global Health Security at Chatham House.
“If they had continued, now we would have a vaccine platform into which you could put a related virus” — like MERS, which has killed some 600 people and is not yet extinguished.