Breakthroughs Blog: Ebola

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. The World Health Organization (WHO) has announced a clinical trial of one or possibly two experimental vaccines designed to protect against the rare Sudan strain of the Ebola virus that has been identified in the recent, rapid outbreak in Uganda. The trial could begin within weeks depending on the Ugandan government’s permission, which is expected soon, as well as regulatory and ethics review approvals. The trial was announced by the WHO’s Health Emergencies Program, which has been conferring to identify vaccines that are far enough along in their development to undergo clinical testing. There are six vaccine candidates in development that are designed to target the Sudan strain, only half of which have advanced to the stage of human clinical trials. Of those, a candidate developed by the Sabin Vaccine Institute and the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases is the furthest along in its development. Dengue resurged across Asia following a period of lower transmission due to reduced mobility because of COVID-19 restrictions, but an exciting vaccine has the potential to make huge strides in reducing the burden of the disease not only in the region but around the world. In August, Indonesia became the first country in the world to approve Takeda’s Qdenga, or TAK-003, vaccine for use against dengue in 6- to 45-year-olds. Qdenga showed incredibly promising results in clinical trials and is under review by the European Medicines Agency and other regulatory agencies in dengue-endemic countries, although it is yet to receive WHO prequalification. The vaccine addresses the complexity of dengue’s four strains by using a weakened version of the DENV 2 strain as its base and including genes from the other three strains.In 2020, a clinical trial in South Africa testing PrEP as a shot delivered every few months found incredible success with results showing high efficacy compared to the daily pill. The drug used in the trial (long-acting cabotegravir or Cab-LA) made by ViiV Healthcare has only been awarded regulatory approval in the United States to date. Access to the shot in low- and middle-income countries has been hampered by the company’s decision to not grant licenses for generic makers to produce the drug at a lower cost. The company has made an agreement with the Medicines Patent Pool that permits three or fewer companies to make generic versions of the drug in 90 low- and middle-income countries, but it could take at least three years for regulatory approval. Viiv Healthcare has submitted its drug for WHO prequalification, which could speed up this approval process. 

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. In a new report, the US Department of Health and Human Services’ (HHS’) Office of the Inspector General (OIG) analyzed the US Food and Drug Administration’s (FDA’s) policies during the COVID-19 pandemic response and made recommendations for improving responses to future health emergencies. The report recognized several strong practices including the creation of templates for emergency use authorization (EUA) submissions and communication forums for the agency and developers. However, continual policy shifts and the decision to ease EUA requirements, possibly leading to the authorization of substandard assays, to increase the availability of COVID-19 tests were among the challenges identified. The report’s six recommendations include a revised device-tracking platform to facilitate the EUA submission process, formal communication channels with the lab community, and a national testing strategy.The messenger RNA (mRNA) hub, established last year in South Africa with support from the World Health Organization (WHO), began development of an mRNA vaccine for tuberculosis. The hub’s objective is to develop inoculations to address high-burden diseases in low- and middle-income countries. It is also working on developing a local mRNA vaccine candidate for COVID-19 (which will enter human trials in the coming months) after low- and middle-income countries faced major challenges accessing COVID-19 vaccines during the pandemic. The first approved mRNA vaccines were developed for the COVID-19 pandemic, but the technology has potential to accelerate vaccine development for other diseases as well, including tuberculosis.Last week, the government of Uganda declared an outbreak of a relatively rare strain of Ebola. The Sudan strain has not been reported globally in a decade and there is no approved vaccine to use against it. The rVSV-ZEBOV vaccine, or Ervebo, is currently used across Africa to limit the spread of Ebola outbreaks but it is only approved for the Zaire strain, which is responsible for the majority of outbreaks. However, WHO has pointed to a different Johnson & Johnson vaccine that has potential in targeting the Sudan strain, which could be confirmed through testing.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. A clinical trial is launching to evaluate a new Ebola vaccine that could protect against multiple species of the virus. While effective vaccines against Ebola have been developed in recent years, they have been approved for only one of the four species of the Ebola virus—the Zaire species, which is responsible for many outbreaks and has the highest mortality rate. Researchers at the University of Oxford are now starting human trials of a new vaccine designed to protect against the Sudan species in addition to the Zaire species, which together have caused almost all of the Ebola outbreaks and deaths. The vaccine is based on the same underlying technology used for the Oxford-AstraZeneca COVID-19 vaccine.Regeneron’s antibody cocktail reduced the risk of COVID-19 infection by 81.6 percent over a period of two to eight months, according to phase 3 trial results announced last week. Previously reported results from the trial had shown REGEN-COV to reduce risk of infection during the first month after administration; the new results demonstrate potential for the drug to provide more long-lasting preventive immunity, which could be an important tool for those who do not respond to COVID-19 vaccines, including people who are immunocompromised. The antibody cocktail is currently authorized in the United States and European Union to treat non-hospitalized patients who are already infected and at high risk of severe illness and in certain cases as a post-exposure prophylaxis.GlaxoSmithKline (GSK) and Vir Biotechnology announced on Friday that their COVID-19 antibody treatment, sotrovimab, works as well when given as a shot in the arm as when administered via standard infusion. Intramuscular injection could offer additional convenience for delivery of the treatment, as it can be performed by family doctors in non-hospital settings. Sotrovimab is authorized for emergency use in the United States to mitigate progression of mild and moderate cases of COVID-19, and the European Medicines Agency has greenlit its use by member states, though EU-wide approval is still outstanding. GSK plans to speak to global regulators, including the US Food and Drug Administration, about approval for the new method of administration.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign-up now to receive our weekly R&D News Roundup email.Last Wednesday, the United Kingdom authorized AstraZeneca and the University of Oxford’s COVID-19 vaccine, giving the candidate its first regulatory greenlight and providing the country with its second vaccination option. The two-dose AstraZeneca/Oxford vaccine—of which a two-dose, full-strength regimen showed 62 percent efficacy in clinical trials—is low cost and easy to handle, as it can be stored in refrigerators rather than ultra-cold or freezer temperatures that other vaccines require. The United Kingdom has also updated its distribution strategy and will allocate the first vaccine dose of both vaccines to as many people as possible before circling back within 12 weeks, rather than 3, to provide the second dose, instead of holding large amounts in reserve for the second shot. By providing more people with quicker access to the first dose, the hope is to enable the greatest number of eligible people to receive some level of protection in the shortest time possible. Rollout of the AstraZeneca/Oxford vaccine in the United Kingdom begins today.The World Health Organization (WHO) on Thursday issued an emergency use validation for Pfizer and BioNTech’s COVID-19 vaccine, the first COVID-19 vaccine authorization the agency has made. The emergency validation allows some countries to expedite their own regulatory approval processes for the candidate, as well as allows UNICEF and the Pan-American Health Organization to acquire and deliver the vaccine to countries in need. In its statement, WHO also emphasized the need for equitable global access to COVID-19 vaccines and urged a global effort to ensure enough vaccine supply for priority populations around the world. The two-dose Pfizer/BioNTech vaccine, which was shown to have 95 percent efficacy in clinical trials, requires a strict cold chain that could pose a challenge to distribution in many countries.The US Food and Drug Administration (FDA) has approved Ridgeback Biotherapeutics’ Ebanga drug to treat Ebola. The endorsement makes Ebanga the second FDA-approved Ebola therapeutic, following approval of Regeneron’s Inmazeb in October. The two treatments, both antibody therapies, were tested in a trial conducted during the 2018-19 Ebola outbreak in Democratic Republic of the Congo against standard-of-care therapies Zmapp and remdesivir for the control arm. Trial data indicated patients who received Ebanga were more likely to survive than those in the control group. Among those receiving the treatment, 35.1 percent died compared to 49.4 percent in the control group. The 11th and most recent Ebola outbreak in the Democratic Republic of the Congo was identified in June and declared over in mid-November.