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Shielding Africa, Protecting the World: Unleashing the Power of Preventative Use of Ebola Vaccines

Received: 11 January 2024    Accepted: 23 February 2024    Published: 13 March 2024
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Abstract

Africa CDC recently conducted a comprehensive risk ranking assessment of epidemic-prone diseases across the continent, identifying Ebola as one of the top 19 infectious diseases with the highest scores in disease severity risk and epidemic potential. The Ebolaviruses first described in the Democratic Republic of the Congo (DRC) in 1976 have left a harrowing trail across sub-Saharan Africa, triggering no less than 34 Ebola outbreaks in 11 sub-Saharan Africa countries, a statistic further compounded by the recent outbreak in Uganda in 2022. At present, the World Health Organization (WHO) has approved two Ebola vaccines, including Ervebo and two-component Zabdeno and Mvabea boost vaccines, for use by individuals above the age of 1 year, including pregnant women as per the Strategic Advisory Group of Experts on Immunization (SAGE) recommendations. The use of these vaccines has demonstrated noteworthy efficacy in safeguarding against Ebola in most African communities and frontline health workers in Ebola-endemic countries such as Sierra Leone, Guinea, and Liberia, among others. Unfortunately, the uptake of these vaccines in Ebola-endemic countries remains dishearteningly constrained despite their availability due to, among other things, the unpredictable timing of outbreaks, sub-optimal surveillance, vaccine demand volatility, palpable vaccine hesitancy, and fragile health infrastructure. Addressing these challenges requires a multifaceted approach that includes a synergy of partnerships between governments, communities, development partners, and private sector partners, such as pharmaceuticals. Recognizing that outbreaks originate and seize at the community level, the imperative of confronting hesitancy through sustained proactive community engagement and utilizing promising vaccination strategies such as ring vaccination must be encouraged. Governments must increase investments to strengthen the regulatory environment for timely access to vaccine stockpiles, robust and cost-effective Ebola vaccination programs for at-risk populations, and preventative use for the health workforce. The International Coordinating Group (ICG) on Vaccine Provision also recommends that national and international health authorities initiate vaccine access by submitting a request to the ICG. This opportunity is at no cost for GAVI-eligible countries and on a reimbursement basis for non-eligible countries. In parallel, Africa CDC is also working closely with Member States on the continent to increase availability and access to medical countermeasures, which include therapeutics, vaccines, and diagnostics, making it critical that Africa CDC is included in the ICG. This will promote timely issue profiling and resolution for increased demand for vaccine stockpiles across the continent where they are needed most as the continent moves towards enhanced health security.

Published in International Journal of Infectious Diseases and Therapy (Volume 9, Issue 1)
DOI 10.11648/j.ijidt.20240901.11
Page(s) 1-6
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Ebola, Vaccines, Sub-Saharan Africa, ICG, SAGE, Africa CDC, Health Security

References
[1] Salmon DA, Dudley MZ, Glanz JM, Omer SB. Vaccine Hesitancy: Causes, Consequences, and a Call to Action. Am J Prev Med [Internet]. 2015 Nov 1 [cited 2023 Sep 28]; 49(6): S391–8. Available from: http://www.ajpmonline.org/article/S0749379715003141/fulltext
[2] Rugarabamu S, Mboera L, Rweyemamu M, Mwanyika G, Lutwama J, Paweska J, et al. Forty-two years of responding to Ebola virus outbreaks in Sub-Saharan Africa: a review. BMJ Glob Health [Internet]. 2020 Mar 1 [cited 2023 Sep 26]; 5(3): e001955. Available from: https://gh.bmj.com/content/5/3/e001955
[3] Elston JW, Cartwright C, Ndumbi P, Wright J. The health impact of the 2014-15 Ebola outbreak. Public Health. 2017 Feb; 143: 60-70. https://doi.org/10.1016/j.puhe.2016.10.020. Epub 2016 Nov 29. PMID: 28159028. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9159599/
[4] Onyekuru NA, Ihemezie EJ, Ezea CP, Apeh CC, Onyekuru BO. Impacts of Ebola disease outbreak in West Africa: Implications for government and public health preparedness and lessons from COVID-19. Sci Afr. 2023 Mar; 19: e01513. https://doi.org/10.1016/j.sciaf.2022.e01513. Epub 2022 Dec 17. PMID: 36570591; PMCID: PMC9759305.
[5] CDC. History of Ebola Disease Outbreaks | History | Ebola (Ebola Virus Disease) | CDC [Internet]. 2023 [cited 2023 Sep 26]. Available from: https://www.cdc.gov/vhf/ebola/history/chronology.html
[6] Munster VJ, Bausch DG, de Wit E, Fischer R, Kobinger G, Muñoz-Fontela C, et al. Outbreaks in a Rapidly Changing Central Africa — Lessons from Ebola. New England Journal of Medicine [Internet]. 2018 Sep 27 [cited 2023 Sep 27]; 379(13): 1198–201. Available from: https://www.nejm.org/doi/10.1056/NEJMp1807691
[7] Malik S, Kishore S, Nag S, Dhasmana A, Preetam S, Mitra O, León-Figueroa DA, Mohanty A, Chattu VK, Assefi M, Padhi BK, Sah R. Ebola Virus Disease Vaccines: Development, Current Perspectives & Challenges. Vaccines (Basel). 2023 Jan 26; 11(2): 268. https://doi.org/10.3390/vaccines11020268. PMID: 36851146; PMCID: PMC9963029.
[8] Sharma AR, Lee YH, Nath S, Lee SS. Recent developments and strategies of Ebola virus vaccines. Curr Opin Pharmacol. 2021 Oct; 60: 46-53. https://doi.org/10.1016/j.coph.2021.06.008. Epub 2021 Jul 27. PMID: 34329960.
[9] Sridhar S. Clinical development of Ebola vaccines. Ther Adv Vaccines. 2015 Sep; 3(5-6): 125-38. https://doi.org/10.1177/2051013615611017. PMID: 26668751; PMCID: PMC4667768.
[10] Henao-Restrepo AM, Camacho A, Longini IM, Watson CH, Edmunds WJ, Egger M, Carroll MW, Dean NE, Diatta I, Doumbia M, Draguez B, Duraffour S, Enwere G, Grais R, Gunther S, Gsell PS, Hossmann S, Watle SV, Kondé MK, Kéïta S, Kone S, Kuisma E, Levine MM, Mandal S, Mauget T, Norheim G, Riveros X, Soumah A, Trelle S, Vicari AS, Røttingen JA, Kieny MP. Efficacy and effectiveness of an rVSV-vectored vaccine in preventing Ebola virus disease: final results from the Guinea ring vaccination, open-label, cluster-randomized trial (Ebola Ça Suffit!). Lancet. 2017 Feb 4; 389(10068): 505-518. https://doi.org/10.1016/S0140-6736(16)32621-6. Epub 2016 Dec 23. Erratum in: Lancet. 2017 Feb 4; 389(10068): 504. Erratum in: Lancet. 2017 Feb 4; 389(10068): 504. PMID: 28017403; PMCID: PMC5364328.
[11] WHO. Ebola virus disease [Internet]. 2023 [cited 2023 Sep 26]. Available from: https://www.who.int/health-topics/ebola#tab=tab_3
[12] WHO. Report of the Strategic Advisory Group of Experts (SAGE) on Immunization. 2018 Oct [cited 2023 Sep 28]; Available from: https://iris.who.int/bitstream/handle/10665/276544/WER9349.pdf?ua=1
[13] Muhammed O Afolabi, Ph.D, David Ishola, Ph.D., Daniela Manno, MD, Babajide Keshinro, FWACP, Viki Bockstal, Ph.D., Baimba Rogers, MSc, et al. Safety and immunogenicity of the two-dose heterologous Ad26. ZEBOV and MVA-BN-Filo Ebola vaccine regimen in children in Sierra Leone: a randomized, double-blind, controlled trial. Published: September 13, 2021. DOI: https://doi.org/10.1016/S1473-3099(21)00128-6
[14] Higgs ES, Dubey SA, Coller BAG, Simon JK, Bollinger L, Sorenson RA, et al. Accelerating vaccine development during the 2013–2016 West African ebola virus disease outbreak. Curr Top Microbiol Immunol [Internet]. 2017 [cited 2023 Sep 27]; 411: 229–61. Available from: https://link.springer.com/chapter/10.1007/82_2017_53
[15] Raphaëlle Deraspe, Brian Hermon. Ebola Virus Disease: Outbreaks, Vaccines and Key Lessons [Internet]. 2021 [cited 2023 Sep 30]. Available from: https://hillnotes.ca/2021/11/12/ebola-virus-disease-outbreaks-vaccines-and-key-lessons/
[16] Tomori O, Kolawole MO. Ebola virus disease: current vaccine solutions. Curr Opin Immunol [Internet]. 2021 [cited 2023 Sep 23]; 71: 27–33. Available from: https://doi.org/10.1016/j.coi.2021.03.008
[17] Rodó X, San-José A, Kirchgatter K, López L. The need for a new strategy for Ebola vaccination. Nature Medicine 2021 27: 4 [Internet]. 2021 Apr 5 [cited 2023 Sep 23]; 27(4): 580–1. Available from: https://www.nature.com/articles/s41591-021-01313-w
[18] Ajelli M, Merler S, Fumanelli L, Pastore y Piontti A, Dean NE, Longini IM, et al. Spatiotemporal dynamics of the Ebola epidemic in Guinea and implications for vaccination and disease elimination: A computational modeling analysis. BMC Med [Internet]. 2016 Sep 7 [cited 2023 Sep 25]; 14(1): 1–10. Available from: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0678-3
[19] Doshi RH, Fleming M, Mukoka AK, Carter RJ, Hyde TB, Choi M, et al. Vaccination of contacts of Ebola virus disease survivors to prevent further transmission. Lancet Glob Health [Internet]. 2020 Dec 1 [cited 2023 Sep 25]; 8(12): e1455–6. Available from: http://www.thelancet.com/article/S2214109X2030454X/fulltext
[20] WHO. Second Ebola vaccine to complement "ring vaccination" given green light in DRC [Internet]. 2019 [cited 2023 Oct 3]. Available from: https://www.who.int/news/item/23-09-2019-second-ebola-vaccine-to-complement-ring-vaccination-given-green-light-in-drc
[21] Abdul-Rahman T, Lawal L, Meale E, Ajetunmobi OA, Toluwalashe S, Alao UH, et al. Inequitable access to Ebola vaccines and the resurgence of Ebola in Africa: A state of arts review. J Med Virol [Internet]. 2023 Aug 1 [cited 2023 Sep 27]; 95(8): e28986. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.28986
[22] Moon S, Sridhar D, Pate MA, Jha AK, Clinton C, Delaunay S, et al. Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola. thelancet.com [Internet]. 2015 [cited 2023 Sep 30]; 386: 2204–25. Available from: http://dx.doi.org/10.1016/
[23] Buseh AG, Stevens PE, Bromberg M, Kelber ST. The Ebola epidemic in West Africa: challenges, opportunities, and policy priority areas. Nurs Outlook. 2015 Jan-Feb; 63(1): 30-40. https://doi.org/10.1016/j.outlook.2014.12.013. Epub 2014 Dec 17. PMID: 25645480; PMCID: PMC7111626.
[24] WHO. UNICEF, WHO, IFRC and MSF announce the establishment of a global Ebola vaccine stockpile [Internet]. 2021 [cited 2023 Sep 24]. Available from: https://www.who.int/news/item/12-01-2021-unicef-who-ifrc-and-msf-announce-the-establishment-of-a-global-ebola-vaccine-stockpile
[25] Doshi RH, Garbern SC, Kulkarni S, Perera SM, Fleming MK, Muhayangabo RF, et al. Ebola vaccine uptake and attitudes among healthcare workers in North Kivu, Democratic Republic of the Congo, 2021. Front Public Health [Internet]. 2023 Jul 25 [cited 2023 Sep 25]; 11: 1080700. Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1080700/full
[26] Folayan MO, Yakubu A, Haire B, Peterson K. Ebola vaccine development plan: Ethics, concerns and proposed measures. BMC Med Ethics [Internet]. 2016 Feb 8 [cited 2023 Sep 22]; 17(1): 1–8. Available from: https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-016-0094-4
[27] Marzi A, Mire CE. Current Ebola Virus Vaccine Progress. BioDrugs [Internet]. 2019 Feb 1 [cited 2023 Sep 23]; 33(1): 9–14. Available from: https://link.springer.com/article/10.1007/s40259-018-0329-7
[28] Woolsey C, Geisbert TW. Current state of Ebola virus vaccines: A snapshot. PLoS Pathog. 2021 Dec 9; 17(12): e1010078. https://doi.org/10.1371/journal.ppat.1010078. PMID: 34882741; PMCID: PMC8659338.
[29] Coltart CEM, Lindsey B, Ghinai I, Johnson AM, Heymann DL. The Ebola outbreak, 2013–2016: old lessons for new epidemics. Philosophical Transactions of the Royal Society B: Biological Sciences [Internet]. 2017 May 26 [cited 2023 Sep 27]; 372(1721): 2013–6. Available from: https://royalsocietypublishing.org/doi/10.1098/rstb.2016.0297
Cite This Article
  • APA Style

    Tegegne, M. A., Gitahi, G., Kimathi, G., Kiarie, J. (2024). Shielding Africa, Protecting the World: Unleashing the Power of Preventative Use of Ebola Vaccines. International Journal of Infectious Diseases and Therapy, 9(1), 1-6. https://doi.org/10.11648/j.ijidt.20240901.11

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    ACS Style

    Tegegne, M. A.; Gitahi, G.; Kimathi, G.; Kiarie, J. Shielding Africa, Protecting the World: Unleashing the Power of Preventative Use of Ebola Vaccines. Int. J. Infect. Dis. Ther. 2024, 9(1), 1-6. doi: 10.11648/j.ijidt.20240901.11

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    AMA Style

    Tegegne MA, Gitahi G, Kimathi G, Kiarie J. Shielding Africa, Protecting the World: Unleashing the Power of Preventative Use of Ebola Vaccines. Int J Infect Dis Ther. 2024;9(1):1-6. doi: 10.11648/j.ijidt.20240901.11

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  • @article{10.11648/j.ijidt.20240901.11,
      author = {Merawi Aragaw Tegegne and Githinji Gitahi and George Kimathi and Jackline Kiarie},
      title = {Shielding Africa, Protecting the World: Unleashing the Power of Preventative Use of Ebola Vaccines},
      journal = {International Journal of Infectious Diseases and Therapy},
      volume = {9},
      number = {1},
      pages = {1-6},
      doi = {10.11648/j.ijidt.20240901.11},
      url = {https://doi.org/10.11648/j.ijidt.20240901.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20240901.11},
      abstract = {Africa CDC recently conducted a comprehensive risk ranking assessment of epidemic-prone diseases across the continent, identifying Ebola as one of the top 19 infectious diseases with the highest scores in disease severity risk and epidemic potential. The Ebolaviruses first described in the Democratic Republic of the Congo (DRC) in 1976 have left a harrowing trail across sub-Saharan Africa, triggering no less than 34 Ebola outbreaks in 11 sub-Saharan Africa countries, a statistic further compounded by the recent outbreak in Uganda in 2022. At present, the World Health Organization (WHO) has approved two Ebola vaccines, including Ervebo and two-component Zabdeno and Mvabea boost vaccines, for use by individuals above the age of 1 year, including pregnant women as per the Strategic Advisory Group of Experts on Immunization (SAGE) recommendations. The use of these vaccines has demonstrated noteworthy efficacy in safeguarding against Ebola in most African communities and frontline health workers in Ebola-endemic countries such as Sierra Leone, Guinea, and Liberia, among others. Unfortunately, the uptake of these vaccines in Ebola-endemic countries remains dishearteningly constrained despite their availability due to, among other things, the unpredictable timing of outbreaks, sub-optimal surveillance, vaccine demand volatility, palpable vaccine hesitancy, and fragile health infrastructure. Addressing these challenges requires a multifaceted approach that includes a synergy of partnerships between governments, communities, development partners, and private sector partners, such as pharmaceuticals. Recognizing that outbreaks originate and seize at the community level, the imperative of confronting hesitancy through sustained proactive community engagement and utilizing promising vaccination strategies such as ring vaccination must be encouraged. Governments must increase investments to strengthen the regulatory environment for timely access to vaccine stockpiles, robust and cost-effective Ebola vaccination programs for at-risk populations, and preventative use for the health workforce. The International Coordinating Group (ICG) on Vaccine Provision also recommends that national and international health authorities initiate vaccine access by submitting a request to the ICG. This opportunity is at no cost for GAVI-eligible countries and on a reimbursement basis for non-eligible countries. In parallel, Africa CDC is also working closely with Member States on the continent to increase availability and access to medical countermeasures, which include therapeutics, vaccines, and diagnostics, making it critical that Africa CDC is included in the ICG. This will promote timely issue profiling and resolution for increased demand for vaccine stockpiles across the continent where they are needed most as the continent moves towards enhanced health security.
    },
     year = {2024}
    }
    

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    AB  - Africa CDC recently conducted a comprehensive risk ranking assessment of epidemic-prone diseases across the continent, identifying Ebola as one of the top 19 infectious diseases with the highest scores in disease severity risk and epidemic potential. The Ebolaviruses first described in the Democratic Republic of the Congo (DRC) in 1976 have left a harrowing trail across sub-Saharan Africa, triggering no less than 34 Ebola outbreaks in 11 sub-Saharan Africa countries, a statistic further compounded by the recent outbreak in Uganda in 2022. At present, the World Health Organization (WHO) has approved two Ebola vaccines, including Ervebo and two-component Zabdeno and Mvabea boost vaccines, for use by individuals above the age of 1 year, including pregnant women as per the Strategic Advisory Group of Experts on Immunization (SAGE) recommendations. The use of these vaccines has demonstrated noteworthy efficacy in safeguarding against Ebola in most African communities and frontline health workers in Ebola-endemic countries such as Sierra Leone, Guinea, and Liberia, among others. Unfortunately, the uptake of these vaccines in Ebola-endemic countries remains dishearteningly constrained despite their availability due to, among other things, the unpredictable timing of outbreaks, sub-optimal surveillance, vaccine demand volatility, palpable vaccine hesitancy, and fragile health infrastructure. Addressing these challenges requires a multifaceted approach that includes a synergy of partnerships between governments, communities, development partners, and private sector partners, such as pharmaceuticals. Recognizing that outbreaks originate and seize at the community level, the imperative of confronting hesitancy through sustained proactive community engagement and utilizing promising vaccination strategies such as ring vaccination must be encouraged. Governments must increase investments to strengthen the regulatory environment for timely access to vaccine stockpiles, robust and cost-effective Ebola vaccination programs for at-risk populations, and preventative use for the health workforce. The International Coordinating Group (ICG) on Vaccine Provision also recommends that national and international health authorities initiate vaccine access by submitting a request to the ICG. This opportunity is at no cost for GAVI-eligible countries and on a reimbursement basis for non-eligible countries. In parallel, Africa CDC is also working closely with Member States on the continent to increase availability and access to medical countermeasures, which include therapeutics, vaccines, and diagnostics, making it critical that Africa CDC is included in the ICG. This will promote timely issue profiling and resolution for increased demand for vaccine stockpiles across the continent where they are needed most as the continent moves towards enhanced health security.
    
    VL  - 9
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Author Information
  • Division of Emergency Preparedness & Response, Africa Centers for Disease Control, Addis Ababa, Ethiopia

  • Global Headquarters, Amref Health Africa, Nairobi, Kenya

  • Institute of Capacity Development, Amref International University, Nairobi, Kenya

  • Global Health Security Unit, Amref Health Africa, Nairobi, Kenya

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