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The Proactive Pessimist: Surveying the Landscape for the Next Pandemic

By Pharmaceutical Processing | October 30, 2015

The summer of 2014 brought with it the like we haven’t seen in years: the outbreak of a deadly virus. It was the first urban Ebola epidemic in history, during which the virus spread across three nations of West Africa.

It is rather interesting to note that Ebola ceased its rapid spreading once it reached the borders of Nigeria—Lago, in particular—as GE Reports points out. In an effort to eradicate polio in years passed, the CDC and international partners helped to establish a public health infrastructure within the country of Nigeria. As a result of this infrastructure, Nigeria was able to prevent Ebola from spreading out of control. Nineteen people were quickly identified as having Ebola in two cities, which helped to cease the outbreak before it spread further. 

Ebola Vaccine

Since that time, there has been talk of an Ebola vaccine. Reports in July of 2015 discussed the VSV–EBOV vaccine, showing that the vaccine was “highly effective” against Ebola in the Guinea Phase III efficacy vaccine trial. The trial began on March 23, 2015 in affected communities, utilizing what some experts have termed as the ‘ring’ vaccination method. In this method, anyone who comes in contact with an infected person is vaccinated—thereby preventing the virus from spreading further. On the 26th of July, the trial was stopped so that anyone at risk could receive the vaccination immediately.

However, October brought with it an update from WHO on the Ebola vaccine. 

“At this time, there are no vaccines to protect against EVD licensed for use in humans,” reports WHO. “Clinical trials for several candidate vaccines are in various phases and a safe and effective vaccine is hoped for by the end of 2015.”
 
At present, there are several vaccines candidates amidst phase I clinical trials: 
 
  1. ChAd3-ZEBOV, developed by GlaxoSmithKline (GSK) in collaboration with the US National Institute of Allergy and Infectious Diseases (NIAID)
  2. VSV-EBOV, developed by NewLink Genetics and Merck Vaccines USA in collaboration with the Public Health Agency of Canada

The results of the trials, thus far, have been promising, as both vaccine candidates have been shown to be safe and well tolerated in humans.

Other countries have clinical trials underway as well:

  • In Guinea and Sierra Leone, Phase II and Phase III clinical trials for VSV-EBOV are underway
  • In Liberia, a Phase II/III study (PREVAIL) was started

Lessons Learned

But while these vaccine candidates are in progress, what is the best way to proceed?

WHO details four lessons from 2014:

  1. “Countries with weak health systems and few basic public health infrastructures in place cannot withstand sudden shocks.”
  2. Preparedness, “including a high level of vigilance for imported cases and a readiness to treat the first confirmed case as a national emergency, made a night-and-day difference.”
  3. “No single control intervention is, all by itself, sufficiently powerful to bring an Ebola epidemic of this size and complexity under control.”
  4. “Community engagement is the one factor that underlies the success of all other control measures.”

How to Stop (or Be Better-Prepared for) the Next Outbreak

The Global Health Security Agenda (GHSA) is a collaborative effort by more than 50 countries to ensure the infrastructure of countries to “prevent, detect, and respond to disease outbreaks,” according to GE Reports.

GHSA includes:

  • A laboratory network
  • Real-time disease surveillance
  • A reporting system on disease outbreaks
  • A workforce medical professionals
  • Emergency operations centers

The CDC has also dictated a list pertaining to Ebola readiness, which includes:

  • Healthcare system preparedness
  • Emergency public warning and information
  • Information sharing between the CDC and healthcare locations
  • Ensure staff has appropriate information for persons traveling who could be exposed to Ebola
  • Public health laboratory testing—ensure that clinical laboratories review lab safety protocols and procedures
  • Public health surveillance
  • Responder safety—have personal protective equipment at the state and local levels

So, what does this mean for pharmaceutical and biopharmaceutical manufacturers?

Well, when it really comes down to it, we rely and wait upon the knowledge and expertise of researchers and experts, such as yourself, for the creation of an Ebola vaccine. And, in the mean time, we should all educate ourselves on how to be proactive in case of another outbreak. 

 

Interested in homework… I mean, further reading? Check out this release from the White House about the Ebola response. 

You may also be interested in:

  • Ebola virus disease fact sheet
  • Ebola signs and symptoms, transmission, risk of exposure, etc.
  • Ebola 2014 outbreaks timeline
  • Ebola: The race for drugs and vaccines
  • Ebola response updates from the FDA
  • The Road to Zero: CDC’s Response to the West African Ebola Epidemic, 2014–2015

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