Can Covid-era vaccine funding help stop a new Ebola outbreak?

Gavi, the Vaccine Alliance is considering deploying a post-Covid emergency vaccine financing mechanism to support development and manufacturing of experimental Ebola vaccines as a fresh outbreak spread across Democratic Republic of the Congo and Uganda.

The outbreak, caused by the Bundibugyo strain of Ebola virus, has already led to more than 500 suspected cases and over 130 deaths in Congo, while confirmed infections have also been reported in Kampala, Uganda, raising concerns over cross-border transmission.

The situation is drawing global attention because there are currently no approved vaccines or therapeutics for Bundibugyo virus disease (BVD). Existing Ebola vaccines, including Merck’s Ervebo, were developed for the Zaire strain of the virus and may not provide protection against the Bundibugyo variant.

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Gavi said it is evaluating whether its First Response Fund (FRF), created following lessons from the Covid-19 pandemic, could be used to support rapid vaccine access and outbreak response measures.

The fund was designed to enable emergency access to vaccines outside Gavi’s regular portfolio through mechanisms such as at-risk procurement and advance purchase commitments aimed at encouraging manufacturers to rapidly produce promising vaccine candidates during health emergencies.

The FRF has a total allocation of $500 million through 2030, with up to $50 million available for rapid deployment at the discretion of Gavi’s chief executive.

Gavi said it is working with partners including Coalition for Epidemic Preparedness Innovations, World Health Organization, Africa Centres for Disease Control and Prevention, UNICEF, the World Bank and private-sector companies to assess experimental vaccine candidates and explore ways to accelerate research and manufacturing.

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Among the candidates under evaluation is a vaccine based on the rVSV platform — the same technology used in the licensed Ebola vaccine Ervebo — but modified for the Bundibugyo strain. However, Gavi said no doses are currently available for clinical trials and manufacturing trial supplies could take six to nine months.

Another vaccine candidate uses the ChAdOx platform, similar to technologies deployed in Covid-19 vaccines, although no animal or human studies have yet been conducted for its use against Bundibugyo virus disease.

“The specific strain causing this outbreak is known as Bundibugyo and has not been seen for over a decade,” said Anaelle Tannen, Senior Infectious Disease Analyst at GlobalData. “While three antivirals and five vaccines are approved for Ebola worldwide, none are effective against the Bundibugyo strain.”

She added that although the World Health Organization has declared the outbreak a Public Health Emergency of International Concern, “this is not expected to become a pandemic”, with the global risk currently assessed as low.

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The World Health Organization has declared the outbreak a Public Health Emergency of International Concern, while Africa CDC has classified it as a Public Health Emergency of Continental Security.

The outbreak is also renewing focus on rapid-response vaccine manufacturing capabilities globally, including in India. Serum Institute of India had partnered with Oxford University during the 2022 Uganda Ebola outbreak to manufacture doses of an experimental Ebola vaccine candidate for emergency response efforts.

Meanwhile, India’s Directorate General of Health Services has issued a health advisory for passengers arriving from or transiting through Ebola-affected countries, including Congo, Uganda and South Sudan, asking travellers with symptoms to immediately report to airport health authorities.

Gavi said the current outbreak is particularly challenging because transmission is occurring among mobile and conflict-affected populations in hard-to-reach regions, complicating surveillance, vaccination and containment efforts.