WHO Ebola Vaccine Meeting Draws Commitment From Pharma, Donors; MSF Sees Need For Concrete Actions

A high-level meeting convened by the World Health Organization yesterday on the issue of access to and financing of Ebola vaccines resulted in a set of commitments, though not with sufficient urgency for those working on the ground. The pharmaceutical industry committed to scale up production, while donors pledged funds without disclosing how deep their pockets might be.

During a press briefing today, Marie-Paule Kieny, WHO assistant director-general for health systems and innovation, said the meeting convened by WHO gathered government representatives, vaccine manufacturers, funding agencies, and civil society. Médecins Sans Frontière (MSF, Doctors without Borders) in a press release [pdf] called for urgent action for frontline workers.

The aim of the meeting, Kieny said, was to discuss and agree on how to fast-track the testing and the deployment of promising vaccines in sufficient numbers to use in the field in 2015.

Three important commitments came from the meeting, she said. First was the commitment of all partners to make sure that efficacy trials start as early as December in affected countries, conditioned by the results of the clinical trials currently ongoing.

Stage one clinical trials have started on the two most advanced vaccines, she said, adding that the preliminary results of those clinical trials would be available in December. Clinical trials have begun in the United States, United Kingdom, and Mali, she said, and will shortly begin in Switzerland, Germany, Gabon and Kenya (IPW, WHO, 21 October 2014). At least five more vaccines are following closely behind, she added, for which clinical trials could start in the first months of 2015.

The second commitment comes from the pharmaceutical industry, which has committed to ramp up production capacity to “millions of doses to be available in 2015, with hundreds of thousand ready in the first half of next year,” she said.

Regulatory authorities both in the countries where the vaccines are manufactured and in Africa will need to work closely with manufacturers to “find ways to outcome a number of hurdles” in the regulation of these vaccines, said Kieny.

Having a few hundred thousand doses available does not mean that all these vaccines could be used immediately, as deployment takes time, she said.

Finally, she said, the third commitment concerns community engagement, which “will be key” and work “should be scaled up urgently” in partnership with local communities, national governments, nongovernmental organisations, and international organisations.

Vaccines are not “a magic bullet,” Kieny cautioned, “but when ready, they may be a good part of the effort to turn the tide of this epidemic.”

No Financing Figures Yet

On financing, Kieny said a number of entities committed to help the financing of the production and deployment of vaccines. For the moment, she said, the current candidate vaccines need cold storage conditions and a lot of investment is needed in logistics.

Médecins Sans Frontières (MSF) pledged, if necessary, to create a fund, while a “number of traditional donor countries” pledged to finance vaccines, she said. However, Kieny said that the amount of the financing had not been discussed yet.

The conclusions [pdf] of a European Council meeting of 23-24 October state that EU member states committed to “increase financial assistance,” which will bring total funding from the EU to 1 billion euros.

The Gavi Alliance is looking into which role they can play in the response to Ebola, she said, adding that Gavi is the main financer for vaccines in developing countries. Gavi is working on a proposal for a strategy that it could take in the vaccines deployment to be presented to its board in December, she noted.

Kieny said that commitments from manufacturers for affordable prices are quite clear. But licensing questions have not been discussed so far, she said.

One of the reasons these vaccines were never developed is that there is no market, she said. So it is doubtful that a lot of manufacturers would be ready to produce Ebola vaccines.

What will be needed when the outbreak is over, is to create stockpiles to have available vaccines to prepare for the next outbreak, she said.

MSF Impatient, Calls For Action

In a press release today, MSF called for significant investment and incentives to accelerate the on-the-ground deployment of Ebola vaccines and treatments, and in particular that they be provided to frontline workers.

“It crucial that people from Ministries of Health, aid agencies and communities who are holding the response to the epidemic together, and ensuring access to essential healthcare, are protected,” said MSF Medical Director Bertrand Draguez. “Resources everywhere are stretched to almost breaking point; everyone is at capacity, but it is extremely hard for the people treating and sustaining the response to do it with absolutely no safety net. Safe and effective treatments and vaccines could offer just that.”

MSF also underlined the need to work on new treatments and diagnostics as well as vaccines to fight Ebola. MSF said it has this week discharged its 1000th patient to have survived Ebola, said it was the first to respond to the Ebola outbreak in West Africa back in April.

“MSF representatives deplored the lack of concrete decisions that were made during the meeting and warned delegates they would not be let off the hook from their responsibilities. While past promises of resources on the ground are slow to be fulfilled – and are urgently needed to be delivered – the need for vaccines and treatments that could prove the tipping point in this outbreak, and prevent future ones, is now critical,” the press release said.

“Large-scale investment in all front-running vaccines, drugs and diagnostics is vital and sufficient resources for clinical trials and post-trial access need to be mobilised by donors now,” they said.

Meeting Participants

According to a WHO press release, meeting participants included: high-ranking officials from the ministries for health and of foreign affairs from Canada, China, the European Union, France, Germany, Guinea, Italy, Japan, Liberia, Mali, Nigeria, Norway, the Russian Federation, Sierra Leone, Switzerland, the United Kingdom, and the United States of America; representatives from SAGE, the African Development Bank, the Bill and Melinda Gates Foundation, the European Federation of Pharmaceutical Industries, the European Investment Bank, the European Medicines Agency, the GAVI Alliance, the London School of Hygiene and Tropical Medicine, Médecins Sans Frontières/Doctors Without Borders, the Paul Erlich Institute, the U.S. Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the Wellcome Trust, and the World Bank; and executives from GlaxoSmithKline (GSK), Johnson & Johnson, Merck Vaccines, and New Link Genetics.”

Image Credits: Flickr – NIAID