Current Ebola Outbreak Raises Concerns
The Ebola virus remains a significant threat, with the ongoing outbreak in Africa representing one of the most alarming epidemics ever faced by health organisations. Nicole Lurie, who has been with the Coalition for Epidemic Preparedness Innovations (CEPI) since 2017 and currently serves as its Executive Director for Preparedness and Response, describes the situation as one of her greatest fears since the COVID-19 pandemic.
Since May, over 7,000 individuals have contracted the Bundibugyo strain of the Ebola virus in the Democratic Republic of Congo (DRC), with approximately half of those infected succumbing to the disease, according to government figures collected by the World Health Organization (WHO).
Rapid Escalation of the Outbreak
This outbreak is characterised as the fastest-growing Ebola crisis on record, with Lurie asserting that it could potentially become the worst the world has ever encountered. Despite health authorities successfully curtailing the outbreak in Uganda through contact tracing, isolation, and clinical care, the instability in the DRC has led to a continuous rise in cases. Ongoing violence has displaced millions, complicating efforts for effective contact tracing, which Lurie describes as a “struggle.” The local population’s distrust of external humanitarian workers has further hindered isolation and treatment efforts, resulting in attacks on Red Cross volunteers and the destruction of medical equipment, including ambulances.
Lurie emphasises the critical need for a vaccine to bring an end to the outbreak.
Vaccine Development Efforts
In response to the initial cases of Bundibugyo reported in May, CEPI promptly allocated $100 million from its internal funding to develop a vaccine. This funding has supported scientists at the Serum Institute of India in rapidly producing doses of the ChAdOx1 BDBV vaccine from the University of Oxford. Additionally, a candidate vaccine from Moderna, also backed by CEPI, has entered the safety trial phase, with efficacy trials anticipated to commence this month.
While CEPI views vaccination as vital to controlling the epidemic, any trials requiring contact tracing are likely to face challenges within affected communities. Teresa Lambe, a professor of vaccinology and immunology at Oxford, expresses concern over the prevailing mistrust towards vaccines, questioning whether even the most effective vaccines would be utilised.
Challenges in Vaccine Rollout
Following the outbreak on a cruise ship in May, Lambe was initially focused on developing a vaccine against hantavirus. However, upon receiving a message from a former WHO employee about the Ebola outbreak, she swiftly redirected her efforts towards initiating a vaccination campaign, securing philanthropic funding even before CEPI formalised its support.
Lambe reflects on the challenges, stating that the current situation is more complex than during the COVID-19 pandemic. “In a way, COVID was easier,” she admits, noting that she has not taken a single day off since May. The ongoing daily life distractions mean that not everyone is aligned in the fight against the epidemic.
International Response Strained
International response organisations have faced staffing shortages, particularly following the United States’ withdrawal from the World Health Organization and the dismantling of USAID during Donald Trump’s second term. Cuts to foreign aid have resulted in shortages of essential medical supplies, including masks, hand sanitiser, and testing materials.
In an email, Emily Hillard, press secretary for the Department of Health and Human Services, outlined the efforts by CDC teams to bolster preparedness in the region through support for epidemiological surveillance, contact tracing, laboratory diagnostics, infection prevention and control, border health activities, community engagement, and other initiatives to contain outbreaks in collaboration with the governments of the DRC, Uganda, and other partners.
Funding Shortfalls Ahead
Despite the U.S. government allocating $50 million in June to support CEPI’s efforts against the Bundibugyo outbreak, Lurie warns that the organisation will run out of funds for its Ebola programme by December unless further financial resources are secured. She stresses the importance of all governments in providing support to combat this epidemic.
Established in 2017 with funding from various governments and the Bill and Melinda Gates Foundation, CEPI was created in response to the extensive Ebola outbreak that highlighted the urgent need to accelerate vaccine development for epidemics. By the time a vaccine was developed and deployed during the West African Ebola epidemic from 2014 to 2016, more than 11,000 lives had been lost, with the outbreak recorded over 1,000 cases.
Lurie, who served as Deputy Assistant Secretary for Preparedness and Response during the Obama administration, recalls the widespread panic and exorbitant costs associated with the 11 Ebola cases reported in the U.S. during that period. “I don’t think anyone wants to go through that again,” she concludes.