World must keep up the fight against Ebola

Published: 11-Dec-2014

There are positive signs that in some areas the battle against the spread of the Ebola virus may be nearing the end, but the war is far from over and now is not the time to relax vigilance

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The world is on the ‘right track’ to defeat Ebola, according to UN Secretary-General Ban Ki-moon. But he urged the international community to remain constant in fighting the disease until it is completely extinguished.

‘The rate of new Ebola virus disease (EVD) cases shows encouraging signs of slowing in some of the hardest-hit parts of Liberia, Guinea and Sierra Leone. The full-scale international strategy to attack Ebola through safe burials, treatment facilities and community mobilisation is paying dividends,’ he confirmed in an article in The Washington Post.

‘Governments and communities in the region are combating the virus. Dozens of countries have stepped up with life-saving contributions. The UN is also partnering closely with regional organisations such as the EU and the African Union, which is mobilising medical professionals and healthcare volunteers from throughout the continent,’ he added.

The UN has been accelerating its Ebola response, including ramped up on-the-ground medical assistance for local governments in affected areas via the UN Mission for Ebola Emergency Response (UNMEER); providing financial support for the countries hardest hit through the World Bank; and monitoring the urgent laboratory testing of an experimental Ebola vaccine.

Recent reports suggest significant decreases in infection rates across many affected areas, fuelling hopes that the target may be within reach

While the UN’s ultimate goal is zero cases in all countries, the stated short-term target is captured by a UN-wide directive aimed at managing and treating 70% of Ebola cases and making safe 70% cent of burials by 1 December. This strategy was the only way to break the exponential curve of infection, stressed Ban. Recent reports from Guinea and Liberia suggest significant decreases in infection rates across many affected areas, fuelling hopes that the target may be within reach.

However, the Secretary-General warned against declaring ‘mission accomplished too soon’, noting that ‘as caseloads go down in some areas, they are rising in others’. In addition, he said, outbreaks had a tendency to flare up again if a gap in the response left space for the disease to spread.

Ban admitted that the crisis had evolved into a complex public health emergency with ‘profound social, economic, humanitarian, political and security dimensions’. He urged international stakeholders to remain vigilant and intensify their responses while also keeping an eye on the underlying causes of the epidemic, most notably by strengthening the region’s health systems. ‘Ebola will be beaten through a resolute and coordinated effort. We have initial evidence that this can happen. But we must speed up efforts to first get the crisis under control and then bring it to an end,’ concluded the Secretary-General. ‘Now is no time to let down our guard. We must keep fighting the fire until the last ember is out.’

In the past, EVD was considered a disease of poverty and therefore commercial interests and benefits were unclear

Meanwhile the WHO has welcomed the European pharmaceutical industry’s fast-track approach to investing in EVD. Speaking to MEPs in Brussels recently, the WHO regional director for Europe Zsuzsanna Jakab said that although in the past, EVD was considered a disease of poverty and therefore commercial interests and benefits were unclear, today that attitude had changed. ‘This is a very positive change,’ said Jakab, alluding to the two vaccines currently in clinical trials, and others that are in the pipeline, but not yet in clinical phase.

‘If all goes well, and safety and security is proven, we can use it at the beginning of next year,’ she said. ‘Convalescence blood from those who have recovered from Ebola has the potential to cure the disease,’ she told Manufacturing Chemist.

The major challenge for Jakab, though, is ‘encouraging the pharmaceutical industry to produce vaccines and treatment also for all poverty diseases and neglected diseases’.

Richard Bergström, Director General of the European Federation of Pharmaceutical Industries and Associations (EFPIA), said his industry had a long history in fighting pervasive infectious disease and that stopping the spread of Ebola was a key priority.

The Ebola+ programme will give the pharmaceutical industry the chance to team up with researchers to find answers to Ebola and other haemorrhagic fevers

‘The pharmaceutical industry, represented by EFPIA, recognises its responsibility and value and is ready to play a vital role,’ he said as a €280m call for proposals for an Innovative Medicines Initiative (IMI) programme was launched. Known as the Ebola+ programme, it will give the pharmaceutical industry the chance to team up with researchers to find answers to Ebola and other haemorrhagic fevers. The EU funding will support projects focusing on the development, manufacturing, transport and storage of vaccines as well as the development of rapid diagnostic tests.

The WHO declared Nigeria Ebola-free on 20 October, after no new cases of the virus had been detected in the previous six weeks. The disease had entered Nigeria on 21 July 2014, through an infected Liberian diplomat. In September, Nigeria’s health minister Professor Onyebuchi Chukwu declared that the Ebola threat had brought out the best in Nigerians, highlighting how the pharmaceutical industry had worked with the federal government, quickly deploying human and financial resources to tackle the outbreak.

‘Ebola has pulled out the spirit of leadership and patriotism from Nigerians and that is why Nigeria is on top of the situation today,’ said the minister.

Noting that anti-Ebola drug ZMapp had not been ‘an automatic cure for the virus’, Emmanuel Ekunno, Managing Director of Nigeria’s Neimeth International Pharmaceuticals, added that his company and others in Nigeria were working hard on research into drugs that could treat the disease, and he was optimistic about making progress. He said that the company had been working with the health ministry to promote hand hygiene products, which would help prevent a wide range of diseases in Nigeria, as well as helping prevent Ebola’s spread.

Nigerian pharma companies have warned that the risk of re-infection remains high while the number of cases is still growing elsewhere in West Africa

Meanwhile, Nigerian pharma companies have warned that the risk of re-infection in the country remains high while the number of cases is still growing elsewhere in West Africa. As a result, the government is maintaining high alerts at all ports of entry. Dr Unni Krishnan, disaster response and preparedness chief for aid group Plan International, said disease isolation centres have been established at Nigerian international airports.

But Ola Ijimakin, General Manager – Marketing for Nigeria’s Fidson Healthcare, told Manufacturing Chemist of his concerns that despite the country’s success in eradicating Ebola, most Nigerian pharma companies could not play an effective role in fighting the disease at present because they had not invested adequately in vaccine manufacturing.

He said the technology and investment required for manufacturing such medicines was too high, making it the domain of multinational companies such as GlaxoSmithKline, Novartis, Sanofi Pasteur and Pfizer. ‘Most of the funds used by the government to purchase vaccines are donor funds,’ he said. ‘There are a lot of rules tied to these funds, including WHO pre-qualification of the product. The process is capital intensive.’

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