Completing the Development of Ebola Vaccines

Jan 17, 2017 – At a time when public attention is diverted from Ebola and the sense of urgency that propelled a rapid public health response in 2014 and 2015 has faded, the push to bring an Ebola vaccine to licensure and fully prepare the world for the next outbreak must not abate, according to the third report from the Ebola Vaccine Team B, a partnership between the Wellcome Trust and CIDRAP.

Today's report, "Completing the Development of Ebola Vaccines," comes less than a year after Team B's second report and is its third in 3 years. The first report detailed desirable qualities to seek in Ebola vaccines and included a host of recommendations for rapid response, and the second focused on four areas key to the development of Ebola vaccines.

The third report highlights the impressive achievement of a successfully completed field efficacy trial of Merck's rVSV-ZEBOV vaccine, but it points out that, although this vaccine is furthest along the regulatory pathway, it is not yet licensed.

The Team B experts call for reinvented global leadership to complete the complex task of licensing and delivering safe, effective, and durable multi-strain Ebola vaccines for preventing outbreaks and quickly stopping future outbreaks when they occur. This step is critical, they write, for Ebola preparedness and to prove that vaccines to protect against other neglected or emerging infectious diseases can be successfully developed in the future.

Team B was rapidly assembled in November 2014 by the Wellcome Trust and the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota as the Ebola outbreak heated up in West Africa. The expert committee is called "Team B" in recognition of the principal role played by the WHO and national governments in leading the international Ebola response.

The new report focuses on six areas: (1) key readiness gaps, (2) current progress on Ebola vaccines, (3) remaining steps for rVSV-ZEBOV, (4) challenges for other vaccine candidates, (5) hurdles for manufacturers, and (6) leadership and coordination of vaccine efforts.

The experts offer 11 recommendations. The first one focuses on restructuring leadership for Ebola vaccine preparedness. The group writes, "Consideration should be given to establishing a dedicated consortium focused on 'championing' Ebola vaccines and resolving the remaining key issues related to global Ebola emergency preparedness (similar to what has been done with meningococcal and malaria vaccine initiatives)."

Other recommendations center on hurdles that vaccine manufacturers face; promotion of scientific collaboration; exploration of using vaccines for people at high risk, such as healthcare workers, before an outbreak occurs; clarification of steps for regulatory approval; planning for additional clinical trials; and development of strategies for post-licensure trials.

Much done; more needed

"Much has been done to secure effective and safe Ebola vaccines, but in fact much more needs to be done to address the challenge of a large outbreak, where public health is unprepared to quickly stop virus transmission." said Michael Osterholm, PhD, MPH, CIDRAP director. Osterholm serves as co-chair of the Ebola Vaccine Team B along with Jeremy Farrar, MD, PhD, director of the London-based Wellcome Trust.

"We must maintain the sense of urgency that has pushed this work forward in previous years. By identifying diseases that are likely to be a threat, we can get ahead of the curve to develop promising diagnostics, drugs and vaccines to ensure we can respond quicker and save more lives. The success of future efforts will depend on our continued action with the Ebola vaccine, and we call on the global community to commit to overcoming the remaining hurdles," Farrar said.

"By evaluating the current situation and developing these recommendations, we hope to galvanize global leadership on the path toward achieving comprehensive Ebola preparedness," Osterholm said.

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