Over a month after the declaration of an Ebola outbreak in Uganda in September 2022 the WHO, CEPI, and Gavi issued a statement on the situation. Observing the spread to 7 districts and acknowledging the government-led response, these organisations have “outlined a plan”. The plan will “accelerate research”, “ensure access to investigational doses” and “facilitate scaling up and access to any subsequent licensed vaccine”.
The statement in November 2022 identifies the importance of vaccination in outbreaks such as this one. However, as there are no licensed vaccines or therapeutics for the Sudan ebolavirus, all efforts are being directed towards the candidates that might be suitable.
“By embedding research at the heart of the outbreak response, we can achieve two goals: to evaluate potentially efficacious candidate vaccines, and to potentially contribute to end this outbreak, and protect populations at risk in the future.”
Vaccine and therapeutics trials have been designated to the Makerere University Lung Institute. With support from WHO, CEPI, and Gavi, there should be enough doses for trial “and beyond”. Candidates in consideration include vaccines from the University of Oxford and the Serum Institute of India, and the Sabin Vaccine Institute and BARDA. Further overall support has been offered from organisations such as Africa CDC, UNICEF, and the African Vaccine Regulatory Forum (AVAREF).
A statement of intent
The statement outlined a series of goals that are “likely to evolve” as the outbreak continues.
- Short term support to the Ministry of Health of Uganda’s outbreak response, including support of a randomised clinical trial to evaluate vaccine candidates.
- Mid-term allocation of resources to “plan for and to reserve sufficient manufacturing capacity” for the scale up of vaccine candidates, potentially through a “risk-sharing mechanism”. This might involve manufacturing additional vaccines during the trial to “ensure that doses of a vaccine found to be efficacious” is readily available.
- Longer term exploration of pathways to ensure that licensed SUDV vaccine(s) are available via the Ebola stockpile.
- Commitment to a mechanism to “ensure equitable access and funding for SUDV vaccines research, outbreak response, and preventative vaccination”.
The collaborators have committed to be “guided by the following principles”:
- Leverage organisational strengths towards a common goal.
- Country driven and country engaged.
- Decision making which is evidence-informed and considers access.
- End-to-end approach based on access and equity.
- Efficient resource allocation.
- Research integrity and ethics.
As the outbreak continues to claim lives across more areas, the importance of this collaboration is clear. Furthermore, the emphasis on following the leadership of the Ugandan ministries is of note; will they be able to maintain this approach?
For more on tackling Ebola with vaccines come to the World Vaccine Congress in Washington 2023.