Racing against time on Ebola vaccine research
On 13 January 2016, the World Health Organisation (WHO) declared that Liberia – the last country to have live cases of Ebola within its borders – was Ebola free. This was a hard-won victory. Since Ebola first struck in Guinea around Christmas 2013, 11,315 people died in the six countries primarily affected – Liberia, Guinea, Sierra Leone, Nigeria, the US and Mali. In total, the number of reported Ebola cases reached 28, 637.
The virus that spread through West Africa in 2014 was undoubtedly one of the greatest health crises the world has faced this century. One thing was clear: the lack of research into treatment for Ebola and the feasibility of a vaccine had left the world unprotected against this deadly disease, which left a trail of destruction in its wake. But new research into creating a vaccine means that if Ebola strikes again, we will all be better protected.
How the lack of research into an Ebola vaccine left the world undefended
Prior to this outbreak, the impetus to research and develop treatments for Ebola was limited, with no vaccine available. Despite the fact that it had been 40 years since the first Ebola outbreak, so little research into the disease had been conducted over the preceding decades that the medical community was almost as unprepared as it was when Ebola first struck in 1976. The world was faced, as a Director at international NGO Médecins Sans Frontières pointed out, with a “disease of which we know little, and for which we had no cure, no means to prevent and with a lot of diagnostic constraints”.
This lack of research into an Ebola vaccine was attributed by the World Health Organisation as having its roots in economic concerns. “A profit-driven industry does not invest in products for markets that cannot pay,” commented the former WHO Director-General Dr Margaret Chan. “Because Ebola has historically been confined to poor African nations, the R&D incentive is virtually non-existent.”
There were also more clinical challenges for those conducting research into the creation of an Ebola vaccine. Viruses are notoriously more difficult to create vaccines for than bacterial infections, because they need to attach to a receptor cell within the body in order to replicate. In the case of Ebola, it is not yet known what that receptor cell is – in fact, it is likely that there are several different types of receptor cell Ebola can “match” to.
Indeed, as Nancy Sullivan, an official at the US National Institute of Allergy and Infectious Diseases pointed out, some sections of the research community suspected that the creation of an Ebola vaccine was an insurmountable task. “No one thought you could protect with a vaccine, because [Ebola] was so aggressive,” she explained.
Others have defended the lack of research into an Ebola vaccine by noting that notwithstanding its role as global viral bogeyman, Ebola actually kills relatively few people, compared with other diseases for which viable vaccines are still under research - for example malaria, tuberculosis and AIDS. That argument, however, ignores the possibility that Ebola could spread far beyond Africa – a possibility the West Africa Ebola crisis through into sharp relief.
The arms race for Ebola vaccine research in 2014
As the Ebola crisis swept through West Africa, bringing with it social and economic devastation, it was clear that the world needed to expedite its research into the creation of an Ebola vaccine.
The pharmaceutical industry responded accordingly. Scientists at New York’s Albert Einstein College of Medicine announced that through their research into an Ebola vaccine they had identified two antibodies to the virus. Pharma behemoth GSK too indicated that it was conducting research into the feasibility of a vaccine. And the Public Health Agency of Canada’s National Microbiology Laboratory (NML) and the US Army Medical Research Institute of Infectious Diseases launched a compound called Zmapp, although its actual efficacy was deemed to be limited after it missed the statistical threshold that researchers set to prove the drug’s effectiveness.
However, research into one Ebola vaccine proved much more fruitful: the Russian vaccine Evac-Combi.
Rusal’s role in researching the Russian Ebola vaccine
As a major investor and employer in Guinea – the country at the epicentre of the Ebola crisis – Rusal was proactive in supporting the country as it struggled to manage the spread of the disease. To this end, it constructed the $10 million US Centre for Epidemic and Microbiological Research and Treatment (CEMRT), a state-of-the-art medical and research centre in Guinea’s Kindia region.
The centre was always designed with research into an Ebola vaccine in mind, equipped world-class research facilities at Biosafety Level 3 according to international certification and high-precision laboratory equipment.
The site was to become the setting for truly ground-breaking research into an Ebola vaccine. Scientists from CEMRT and a research team from the Russian State Gamaleya Institute for Epidemiology and Microbiology, one of Russia’s leading medical and biological research institutions, carried out extensive research and developed a working model for an Ebola vaccine.
The next stage of research into the Russian Ebola vaccine was completed in March 2016, when testing at the CEMRT facility proved that the vaccine was not only effective, but also had minimal side effects. And in February 2017, the Ebola vaccine – now in two slightly different forms called Gam-Evac Combi and Gam Evac – was presented to the World Health Organisation, which emphasised the importance of this product of extensive research at CEMRT. Rusal’s CEMRT vaccine had been instrumental in producing the first official Ebola vaccine approved for clinical use.
CEMRT’s role in Ebola vaccine research did not end there either. In July 2017, the first 1,000 Ebola vaccine doses were administered at the centre, which will continue its research not only into vaccines and treatments for Ebola, but also for other communicable diseases.
The 2014 Ebola crisis acted as a catalyst for Ebola vaccine research and the discoveries made at Rusal’s CEMRT centre have the potential to save many lives. Should Ebola strike again, the world will be far more ready.