Media/Policy Watch
AFP
At least four months to contain Ebola: Red Cross chief
22 October 2014
Beijing (AFP) – The Ebola epidemic will take at least four months to contain even if all necessary steps are taken, the global head of the Red Cross said Wednesday, warning of “the price for inaction”…
…Elhadj As Sy, chief of the International Federation of Red Cross and Red Crescent Societies, listed a range of measures which would help bring Ebola under control, including “good isolation, good treatment of cases which are confirmed, good, safe and dignified burials of deceased people”.
“It will be possible, as it was possible in the past, to contain this epidemic within four to six months” if the response is adequate, he added.
“I think that is our best prospect and we our doing everything possible to mobilise our resources and our capacities to do so.”
Speaking at an Asia-Pacific IFRC conference, he added: “There is always a price for inaction.”…
Al Jazeera
http://www.aljazeera.com/Services/Search/?q=vaccine
Accessed 25 October 2014
US West Africans facing Ebola stigma
24 Oct 2014
Discrimination on the rise in New York City as locals gossip about those who have lost entire families 7,000km away.
The Atlantic
http://www.theatlantic.com/magazine/
Accessed 25 October 2014
The Psychology of Anti-Vaxers: How Story Trumps Science
An anecdote from a friend can hold more weight than a recommendation from a doctor.
Vanessa Wamsley Oct 19 2014, 8:00 AM ET
BBC
http://www.bbc.co.uk/
http://www.bbc.com/news/health-29752896
24 October 2014 Last updated at 13:57 BST [Video segment]
Millions of doses of an Ebola vaccine will be produced by the end of 2015, the World Health Organization has announced.
And vaccines could be offered to health workers on the frontline in West Africa as soon as December 2014.
Dr Marie Paule Kieny, a WHO assistant director-general, said: “While we hope that the massive response, which has been put in place will have an impact on the epidemic, it is still prudent to prepare to have as much vaccine available if they are proven effective.
Council on Foreign Relations
http://www.cfr.org/
Accessed 25 October 2014
Backgrounder
Ebola Virus
by Danielle Renwick October 24, 2014
Officials say Ebola may have already claimed fifteen thousand lives in West Africa—and the toll is rising.
News Release
Updated Vaccine-Preventable Outbreaks Map Shows Attacks on Vaccinators Drive Polio Outbreaks
October 23, 2014
CFR’s Global Health program has expanded its “Vaccine-Preventable Outbreaks Map,” adding new data showing how a hostile climate for vaccinators thwarts the eradication of preventable illnesses such as polio.
Op-Ed
Vaccine Ignorance — Deadly and Contagious
by Laurie Garrett, Maxine Builder October 23, 2014
In the absence of credible, strong political leadership, paranoia about disease can go viral. Laurie Garrett and Maxine Builder explain how false fears and suspicions are the enemies when it comes to disease prevention in this op-ed for the Los Angeles Times.
Forbes
http://www.forbes.com/
Pharma & Healthcare 10/23/2014 @ 11:44PM 3,091 views
Head of GSK Ebola Vaccine Research: “Can We Even Consider Doing A Trial?”
GlaxoSmithKline is considered by many a leading contender for delivering an Ebola vaccine at scale. Recent quotes by the Head of Ebola vaccine research for GSK, however, are sobering and indicate the enormous challenges ahead in the race to deliver a safe and effective vaccine in the quantities needed for the unprecedented outbreak in West Africa.
“The thing that is going to have the biggest impact is what is happening to the trajectory of the epidemic curve. If you progress the current trends 2 months into the future are we still in an environment where you can even consider doing a trial?” Dr. Ripley Ballou ‒ Head of Ebola Vaccine Research, GSK (via ScienceInsider here)
At the GSK vaccine research facility outside of Brussels, they are working to squeeze 10 years of trial activity into 12 months. The hope is to have 20,000 doses ready to be tested by health workers early next year.
“At the same time we have to be able to manufacture the vaccine at doses that would be consistent with general use, and that’s going to take well into 2016 to be able to do that. I don’t think this [vaccine] can be seen as the primary answer to this particular outbreak. If it does work then to be able to be prepared so that we don’t have to go through this again in five years, or whenever the next epidemic is going to break out.” Dr. Ripley Ballou ‒ Head of Ebola Vaccine Research, GSK (BBC News Health ‒ here)
Earlier today, ScienceInsider published results (here) from leaked documents used in discussions with the World Health Organization (WHO), government officials and vaccine manufacturers.
Included in those documents was this GSK chart outlining a possible timeline for delivering 230,000 vaccines by April 2015 and then scaling to 1 million by December 2015.
Some of the other challenges referenced in their findings include:
:: Producing a vaccine in such large quantities (“fill capacity”) and the effect this would have on other vaccines currently in production (rotavirus, measles, mumps and rubella)
:: Liability relief from regulators for producers and distributors of several vaccine candidates used in multiple human trials
:: Costs estimated at $73 million for 27 million does of the vaccine and another $78 million for the actual vaccine campaigns
:: Safe and secure transport and storage (with needed refrigeration throughout the delivery chain)
Unfortunately, modeling and forecasting the effects of a successful vaccine like the one that GSK and others are working on are less than encouraging. At least one study suggests that while a successful vaccine may reduce the mortality rate of those infected, it will do little to slow the transmission.
“The hypothetical mass application of a novel pharmaceutical like the one administered to two American aid workers had a much smaller impact on the course of the epidemic itself. While certainly lessening the burden of mortality of those infected (in the most optimistic scenario modeled, reducing the case-fatality rate from 50% to 12.5%), the downstream effects of such an intervention are relatively minor, as there is no suggestion that any candidate treatments have a substantial impact on transmission.”
“These results also suggest that the epidemic has progressed beyond the point wherein it will be readily and swiftly addressed by conventional public health strategies. The forecasts for both Liberia and Sierra Leone in the absence of any major effort to contain the epidemic paint a bleak picture of its future progress, which suggests that we are in the opening phase of the epidemic, rather than near its peak.“ Modeling the Impact of Interventions on an Epidemic of Ebola in Sierra Leone and Liberia (Public Library of Science here)
A more accurate forecast of Ebola’s endgame for this outbreak could well be what happened with the 2003 SARS outbreak in China. How to Shut Down A Country and Kill a Disease was written yesterday by Laurie Garrett ‒ a senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize winning science writer. Based on her own first hand experience with SARS in China, she concluded with this assessment:
If the world cannot manage to muster promised monies and mobilize far more personnel and equipment to confront the epidemic, the governments of Sierra Leone, Guinea, and Liberia may be compelled to implement strategies as severe as China’s SARS endgame, dragging thousands into isolation without respect for their rights or civil liberties, and even at gunpoint. The world must not compel such hellish action. The less odious, more humane alternative of building quality treatment centers on a scale to actually absorb thousands of needy patients and provide meaningful care that improves survival and thus lures Ebola sufferers out of hiding could still work today. It is hugely expensive, and it demands thousands of skilled health workers and support staff from all over the world. But in the absence of ample aid, three nations that nobly came back from the horrors of civil war into their dawns of democracy may be forced backward into an Ebola authoritarian horror.
Foreign Affairs
http://www.foreignaffairs.com/
Accessed 25 October 2014
The Poor and the Sick
What Cholera and Ebola Have in Common
By Fran Quigley
October 19, 2014
The two deadliest outbreaks of this century can be traced to one thing: poverty. Cholera exploded in the Haitian countryside in October 2010, infecting more than 600,000 people and killing 8,600. Ebola surfaced this March in Guinea and has since spread to Liberia and Sierra Leone. As of mid-October, more than 8,000 have been infected and 4,000 have died, almost exclusively in West Africa.
At first glance, the two outbreaks couldn’t be less similar. Cholera moves quickly but it is a nineteenth-century disease, easily thwarted by modern water treatment systems and health care. It ravaged Haiti, but it has not spread beyond the developing world. Ebola, on the other hand, moves slowly and is not as easily treated. Further, it has reached the United States, earning it near-obsessive attention in U.S. news. As Greg Gonsalves, co-director of the Yale Global Health Justice Partnership wrote this month in Quartz, “Exotic infections for Americans, often from far away places, often Africa, strike fear into their hearts, but only once the pathogens have cleared customs.” Ebola has cleared customs in a way Haitian cholera never has…
The Guardian
http://www.guardiannews.com/
Accessed 25 October 2014
Ebola outbreak prompts food scarcity and threat of social conflict
Fears are growing that the economic impact of the Ebola crisis could lead to unrest and political crises in west African countries
23 October 2014
Farmers in Liberia are too frightened to work together in their fields, fertilisers and seeds are stuck on the other side of closed borders, markets are almost empty, people have less money because jobs that involve physical contact with others are disappearing, and prices for everything from cassava to palm oil are rising.
It’s a devastating chain reaction sparked by an unprecedented outbreak of disease in one of the world’s poorest countries. Beyond the high mortality rate and human suffering, aid agencies fear the fabric of a society that endured a brutal civil conflict may be ruined.
Ten months after the Ebola outbreak started in Guinea, evidence is mounting that the crisis may be reversing more than a decade of fitful progress in west Africa…
Follow Britain’s example on Ebola, David Cameron tells world leaders
UN chief Ban Ki-moon berates international community for contributing only $100,000 into his $1bn global fighting fund
17 October 2014
Britain has called on world leaders to “wake up” to the crisis posed by the Ebola outbreak and to follow the example of the UK, US and France in providing medical and financial support to countries in West Africa. As the UN secretary general, Ban Ki-moon, chided the international community for paying just $100,000 into his $1bn trust fund to fight Ebola, David Cameron called on other countries to “act in a similar way” to Britain, the US and France…
Funding the fight against Ebola: how much is needed and where will it go?
17 October 2014
The cogs of international aid are finally turning – here’s how the money is being coordinated and what it’s being spent on.
The Ebola crisis has exposed failings in the ability of leading global institutions to respond to an admittedly unprecedented health emergency. As world leaders chide one another for failing to dedicate enough funds to fighting the virus in west Africa, and the consequences of neglecting health systems in some of the world’s poorest countries become ever more obvious, the cogs of international aid are beginning to turn. But the money is only dribbling in slowly, and there are concerns that the virus is already out of control in Liberia, Sierra Leone and Guinea…
The Huffington Post
http://www.huffingtonpost.com/
Accessed 25 October 2014
Ebola: Learning From Past Mistakes
Philippe Douste-Blazy
Under-Secretary General of the United Nations; Chair, UNITAID
22 October 2014
…Ebola casts a harsh spotlight on global health politics and on almost 50 years of health development assistance in Africa. Of course, spectacular progress has been made in recent years in the field of healthcare. Infant mortality has fallen by over 50% in the last 20 years. Nevertheless, what the current Ebola crisis teaches us is the importance of primary healthcare, which is the bedrock of public health. This does not mean spectacular measures but putting in place the solid foundations without which it is impossible to sustainably raise the health level of a population. For decades, unfortunately, the slow and gradual implementation of robust primary health systems has been sacrificed in favor of quicker and more visible results…
NPR
Ebola Is Keeping Kids From Getting Vaccinated In Liberia
NPR Blog | 23 October 2014
…There are a lot of those sicknesses in Liberia. Even before Ebola, more than 7 percent of children here died before reaching age 5. Many of these deaths are from preventable diseases, says Adolphus Clarke, who helps manage the government’s immunization program. …The numbers tell a tragic story. Before Ebola, 97 percent of babies were getting their routine vaccinations. Now the figure is 27 percent. That almost certainly means more children will die, Clarke says….There are already ominous reports from places hit hard by Ebola, says UNICEF’s Sheldon Yett. “We’ve already had cases of measles in Lofa country which was the original epicenter of the disease in Liberia,” he says. “So that’s already happening.”
New York Times
http://www.nytimes.com/
Accessed 25 October 2014
New Protocol on Quarantines Seen as Barrier to Volunteers
By DAVID W. CHEN and LIZ ROBBINS
October 25, 2014
Requirements for isolating people who had contact with Ebola patients, like those announced in the New York area, could dissuade health workers from serving at the front lines of the epidemic….
Wall Street Journal
http://online.wsj.com/home-page?_wsjregion=na,us&_homepage=/home/us
Accessed 25 October 2014
Oct 23, 2014
Ebola
Should Pharma be Indemnified for Ebola Vaccines? Take our Reader Poll
Ed Silverman
In response to the call to quickly develop Ebola vaccines, drug makers would like indemnity from governments or multilateral agencies for the widespread use of their new products in Africa. And the issue is expected to be discussed today at a World Health Organization meeting in Geneva that will include representatives from countries affected by the virus, the pharmaceutical industry, regulators and funding organizations, according to Reuters.
“I think it is reasonable that there should be some level of indemnification because the vaccine is essentially being used in an emergency situation before we’ve all had the chance to confirm its absolute profile,” GlaxoSmithKline chief executive Andrew Witty tells BBC radio, according to Reuters. “That’s a situation where we would look for some kind of indemnification.”
In his view, indemnification would help compensate for the risk that involves fast tracking the supply of novel vaccines in just months instead of years. Witty notes that the WHO has asked drug makers to fast track their efforts. As Reuters notes, drug makers have been leery of investing in Ebola since the commercial opportunity is small, and that any losses or claims represent an added hurdle.
“This is an unprecedented pace of development,” says Witty. “We are literally doing in maybe five or six months would normally take five or six years. I’ve already ordered five production lines to allow us to expand production.”
Glaxo currently has the most advanced vaccine and doses are expected to be available later this year. Another vaccine is being developed by NewLink Genetics have begun and Johnson & Johnson expects to begin testing a vaccine in January, Reuters adds.
Drug makers are not the only ones who believe indemnification is warranted. Brian Greenwood, a professor of clinical tropical medicine at the London School of Hygiene and Tropical Medicine, tells Reuters that “there would have to be some sort of guarantee.”
The meeting in Geneva will look at ways to streamline the development process for vaccines and to ensure there are adequate financial resources available, according to the news service. Europe, for instance, is expected to announce $250 million in funding to develop new Ebola vaccines, as well as drugs and diagnostic tests.
After initial criticism this past summer in some quarters for failing to have previously invested in products to combat Ebola, some drug makers are clearly responding. And rightly so, given that the outbreak may have devastating consequences for infected areas. The effort, of course, also requires investment and the risks of distributing products under such circumstances are clear…
Washington Post
http://www.washingtonpost.com/
Accessed 25 October 2014
Opinions
Michael Gerson: The world is in denial about Ebola’s true threat
It is such a relief about that Ebola thing. The threat of a U.S. outbreak turned out to be overhyped. A military operation is underway to help those poor Liberians. An Ebola czar (what is his name again?) has been appointed to coordinate the U.S. government response. The growth of the disease in Africa, by some reports, seems to have slowed. On to the next crisis.
Except that this impression of control is an illusion, and a particularly dangerous one.
The Ebola virus has multiplied in a medium of denial. There was the initial denial that a rural disease, causing isolated outbreaks that burned out quickly, could become a sustained, urban killer. There is the (understandable) denial of patients in West Africa, who convince themselves that they have flu or malaria (the symptoms are similar to Ebola) and remain in communities. And there is the form of denial now practiced by Western governments — a misguided belief that an incremental response can get ahead of an exponentially growing threat…
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