Safeguarding against Ebola: Vaccines and therapeutics to be stockpiled for future outbreaks

摘要

The Ebola virus outbreak of 2014 to 2016 had severe and devastating consequences for the people of West Africa, with more than 28,000 cases and 11,000 deaths across Liberia, Sierra Leone,and Guinea [1]. This epidemic exposed inadequacies in the medical countermeasure preparedness of international governments and organizations that limited their ability to effectivelyaddress the spread of the Ebola virus. Although Ebola virus had been circulating in Africa fordecades with periodic outbreaks [1], funding for filoviruses has been limited to preclinicalevaluation and establishment of assays and reagents that were necessary to quickly evaluatevaccine and therapeutic candidates. The few medical countermeasures that existed were stalledin early stages of development, a consequence of several factors, including insufficient fundingto advance candidates, an uncertain regulatory path for development, and constraints associated with Biosafety Level 4 containment suites for research using Ebola viruses [2, 3, 4]. As theWest Africa Ebola epidemic grew in scale, governments, international organizations, nongovernment organizations, and industry scrambled to mount an effective response to contain theoutbreak [5]. The United States government (USG) and others invested millions of dollars toaccelerate the development of vaccine, therapeutic, and diagnostic candidates from early preclinical development into manufacturing scale-up and clinical trials [2]. Several of these clinical trials were conducted in West Africa, which offered the potential to have a direct impact onthe ongoing outbreak and demonstrate clinical efficacy of the medical countermeasures. Ultimately, the early development of these medical countermeasures was led by collaborativeefforts across multiple organizations and countries. For example, early development of bothvaccines and therapeutics can be attributed to organizations such as the National Institutes ofAllergy and Infectious Diseases (NIAID), the US Army Medical Research Institute of Infectious Diseases (USAMRIID), the Defense Threat Reduction Agency (DTRA), the MedicalCountermeasure Systems-Joint Vaccine Acquisition Program (MCS-JVAP), and the PublicHealth Agency Canada (PHAC). During the international response to the outbreak, numerousorganizations, institutions, and international governments contributed to the evaluation ofthese medical countermeasures in the field, including the Ministries of Health in Guinea andLiberia, the Ministry of Health and Sanitation in Sierra Leone, the World Health Organization(WHO), and the Wellcome Trust, United Kingdom, to name a few.