Telma Lery - 20 Jul 2021
As we are seeing with COVID-19, there is no denying that, as part of a multi-faceted public health response, vaccinations will help curb a pandemic. But fighting a public health emergency can feel like a battle with the Hydra of Lerna, the many-headed serpent of Greek mythology. With every stride in vaccine development, a new variant or outbreak may occur that prevents us from lowering our guard.
These past few years have certainly been a test for the global pharma industry. To date, we’ve seen six Public Health Emergencies of International Concern (PHEIC); two of which happened within the last three years. This includes the Ebola outbreak in the Democratic Republic of the Congo (DRC).[1],[2],[3]
Ebola has not gone away
Ebola has been relentless. Since it was discovered in 1976, there have been around 30 significant outbreaks in Africa.[4] The 2014–16 epidemic alone claimed more than 11,000 lives across West Africa and had a devastating impact on families, health systems, and economies.[5] At the time, there was little to stop it. There were no effective treatments, approved vaccines, or even widely available point-of-care tests.
In 2018, Ebola reared its head again in the Democratic Republic of the Congo in the world’s second largest outbreak, causing more than 3,000 cases and 2,000 deaths.[6] And again in Guinea in 2021[7], with 16 confirmed and seven probable cases reported– 12 of these tragically resulting in deaths.[8]
But this time around, we were more prepared. In the wake of the 2014 outbreak, Janssen accelerated efforts to develop an Ebola vaccine under the Innovative Medicines Initiative (IMI) Ebola+ programme, a partnership between the European Commission and the European Federation for Pharmaceutical Industries and Associations (EFPIA).[9],[10] The IMI programme includes projects that contribute to vaccines R&D, clinical trials, diagnostics, storage and transport.9
In 2021, we were able to deploy an Ebola vaccine to frontline and healthcare workers as part of the WHO early access clinical programme.[11]
Accelerating process
Over the past few years, local governments, world health bodies, pharmaceutical companies and technical researchers have been working tirelessly and collectively to develop solutions.
The creation of the WHO Research and Development Blueprint initiative in 2016, enabled fast-tracking of effective tests, vaccines, and treatments.[12]A multi-drug clinical trial of ground-breaking new treatments, one of which is now approved by the FDA,[13],[14] demonstrates the accelerated testing and approval of promising new therapies.
To date, two different vaccines have been deployed. In November 2019, MSD’s single‑dose vaccine offering was approved in the EU.[15] A few months later in July 2020 Janssen’s two‑dose regimen was approved in Europe.[16]
The fast-tracked approval of these two vaccines made a big difference in how they were able to be distributed.
Collaboration for a greater circle of protection
For a public health emergency, we can’t rely on one vaccine, one technology platform, one company, or one public health body. We need global alignment between private and public sectors to generate a diversified approach to technology innovation, and to create efficiencies in vaccine development and distribution.
The global health community must continue to recognise the vital role of vaccines in addressing epidemics and pandemics. We must anticipate future outbreaks and ensure robust systems, processes and supply chains are in place. And we must continue to work together, because only then can we hope to tackle the multiple heads of a global public health emergency.
References
[1] Wilder-Smith A, Osman S. Public health emergencies of international concern: a historic overview. J Travel Med. 2020 Dec 23;27(8):taaa227. doi: 10.1093/jtm/taaa227. PMID: 33284964; PMCID: PMC7798963.
[2] WHO. COVID-19 Public Health Emergency of International Concern (PHEIC) Global research and innovation forum. Available from: https://www.who.int/publications/m/item/covid-19-public-health-emergency-of-international-concern-(pheic)-global-research-and-innovation-forum. Last accessed: July 2021.
[3] The Economist. Ebola has been declared an international public health emergency. Available from: https://www.economist.com/middle-east-and-africa/2019/07/18/ebola-has-been-declared-an-international-public-health-emergency. Last accessed: July 2021.
[4] Centers for Disease Control and Prevention (CDC). Years of Ebola Virus Disease Outbreaks. Available from: https://www.cdc.gov/vhf/ebola/history/chronology.html. Last accessed: July 2021.
[5] Centers for Disease Control and Prevention (CDC). 2014-2016 Ebola Outbreak in West Africa. Available from: https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html. Last accessed: July 2021.
[6] World Health Organization (WHO). 10th Ebola outbreak in the Democratic Republic of the Congo declared over; vigilance against flare-ups and support for survivors must continue. 25 June 2020. Available from: https://www.who.int/news/item/25-06-2020-10th-ebola-outbreak-in-the-democratic-republic-of-the-congo-declared-over-vigilance-against-flare-ups-and-support-for-survivors-must-continue Last accessed: July 2021.
[7] BBC News. Guinea declares Ebola epidemic: First deaths since 2016. Available from: https://www.bbc.co.uk/news/world-africa-56060728. Last accessed: July 2021.
[8] WHO. Ebola outbreak in Guinea declared over. Available from: https://www.afro.who.int/news/ebola-outbreak-guinea-declared-over. Last accessed: July 2021.
[9] IMI. Innovative Medicines Initiative launches Ebola+ programme. Available from: https://www.imi.europa.eu/news-eventspress-releases/innovative-medicines-initiative-launches-ebola-programme. Last accessed: July 2021.
[10] J&J. 6 Latest Facts About Johnson & Johnson’s Ebola Vaccine. Available from: https://www.jnj.com/latest-news/latest-facts-about-johnson-johnson-ebola-vaccine. Last accessed: July 2021.
[11] J&J Press release. Johnson & Johnson Joins World Health Organization in Efforts to Prevent Spread of Ebola in West Africa. Available from: https://www.jnj.com/johnson-johnson-joins-world-health-organization-in-efforts-to-prevent-spread-of-ebola-in-west-africa. Last accessed: July 2021.
[12] World Health Organization (WHO). An R&D Blueprint for Action to Prevent Epidemics. Available from: https://cdn.who.int/media/docs/default-source/blue-print/an-randd-blueprint-for-action-to-prevent-epidemics-update-2017.pdf?sfvrsn=4c31073a_1&download=true. Last accessed: July 2021.
[13] U.S. Food & Drug Administration (FDA). FDA approved first treatment for ebola virus. 14 October 2020. Available from: https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-ebola-virus. Last accessed: July 2021.
[14] World Health Organization (WHO). Update on Ebola drug trial: two strong performers identified. August 12, 2019. Available from: https://www.who.int/news-room/detail/12-08-2019-update-on-ebola-drug-trial-two-strong-performers-identified. Last accessed: July 2021.
[15] European Commission. Vaccine against Ebola: Commission grants first-ever market authorisation. Available from: https://ec.europa.eu/commission/presscorner/detail/en/IP_19_6246. Last accessed: July 2021.
[16] European Commission. Vaccine against Ebola: Commission grants new market authorisations. Available from: https://ec.europa.eu/commission/presscorner/detail/en/IP_20_1248. Last accessed: July 2021.
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