Key Takeaways
- MSF is calling for rapid expansion of access to ERVEBO®, the only Ebola vaccine currently available at scale, during the Bundibugyo Ebola outbreak in the DRC.
- No licensed vaccine exists specifically for Bundibugyo ebolavirus, and results from candidate vaccines are still months away.
- ERVEBO® is licensed, has a well-established safety profile, and is authorised for use in individuals aged one year and older.
- Access is currently restricted to research protocols, compassionate-use mechanisms, and clinical trials, which will likely enrol only a small fraction of those who could benefit.
- Animal studies and immunological data show encouraging signs that ERVEBO® may also recognise and respond to Bundibugyo virus.
Waiting Is Not an Option: MSF calls for broader access to ERVEBO® vaccine during Bundibugyo Ebola outbreak
As the Bundibugyo Ebola outbreak continues in the Democratic Republic of Congo (DRC), Médecins Sans Frontières (MSF) is calling for rapid expansion of access to ERVEBO®, the only Ebola vaccine currently available at scale. While vaccines specifically developed against the Bundibugyo virus are still under development and unlikely to be available in the near term, growing evidence and encouraging field observations suggest that ERVEBO® could help protect more people at risk today.
No licensed Bundibugyo-specific vaccine exists, but ERVEBO® is licensed and available
No licensed vaccine currently exists specifically for Bundibugyo ebolavirus. While several candidate vaccines are under study, results are still months away, and for children under 12, evidence generation and potential access to Bundibugyo-specific vaccines may take even longer. By contrast, ERVEBO® is a licensed vaccine with a well-established safety profile, extensive operational experience from previous Ebola responses in DRC, and is currently authorised for use in individuals aged one year and older.
MSF Statement: Do not wait for a Bundibugyo-specific vaccine
Guyguy Manangama, epidemiologist and deputy director of operations at MSF, said:
"For MSF, the absence of a Bundibugyo-specific vaccine should not prevent the use of the only vaccine currently available. Every month spent waiting for dedicated tools leaves healthcare workers, frontline responders, contacts of confirmed cases and affected communities exposed to a potentially deadly disease. Expanding access to ERVEBO® offers the best immediate opportunity to help reduce severe illness and deaths while research on Bundibugyo-specific vaccines continues. Restrictions linking ERVEBO® vaccination to research protocols should be lifted so that available doses can be deployed rapidly to protect those most at risk."
Why access to Ebola vaccination remains highly restricted
At present, access to vaccination remains highly restricted. Frontline workers may be vaccinated through cumbersome research protocols or compassionate-use mechanisms, while contacts of confirmed Ebola cases generally only have access through ongoing clinical trials. Given the strict requirements of these trials, only a small fraction of people who could benefit from vaccination are likely to be enrolled, far short of what would be needed for broad public health deployment. This leaves many at-risk populations without access to vaccination despite the continued spread of the outbreak.
Growing evidence that ERVEBO® may protect against Bundibugyo virus
At the same time, evidence supporting the potential role of ERVEBO® continues to grow.
Although ERVEBO® was not specifically designed for the Bundibugyo virus, a growing body of scientific evidence suggests it may still help protect people exposed to it. Animal studies and immunological data from research in vaccinated individuals have shown encouraging signs that the immune response triggered by ERVEBO® may also recognise and respond to Bundibugyo virus.
Q&A Ebola Disease Outrbreak
The outbreak keeps spreading at an alarming rate. It is currently spreading across Ituri, North Kivu, South Kivu, Tshopo and Haut-Uélé provinces in eastern DRC, with Ituri accounting for more than 90 per cent of cases and the latest official data showing an increased number of confirmed cases in North Kivu.
Based on the latest from the Ministry of Health there are 3,262 confirmed cases and 1437 confirmed deaths in the affected provinces, as of 26 July.
On 9 July, two new provinces were declared as part of the current outbreak: Haut Uélé (Wamba) and Tshopo (Kisangani). An MSF emergency team is present in Kisangi to support local health structures with training for Ebola management and IPC. We have also set up a 12-bed isolation unit in one hospital and will set up an Ebola Treatment Centre (ETC) in an additional location in Kisangani. In Ituri, cases have increased in the Nia-Nia and Nizi health zones. This area is located along the road leading northwest to Isiro and Kisangani, which is highly concerning.
We are facing a large outbreak in a highly complex and challenging environment. In just 10 weeks, the current Ebola diseases outbreak, caused by the Bundibugyo virus, has become the third largest outbreak and the fastest-growing on record, and over the past month the number of cases has tripled while reported deaths have increased more than fivefold. Undeniable progress has been made in several areas, including laboratory capacity-building. However, major challenges remain that jeopardise the control of the outbreak, whether in diagnostics, surveillance, contact tracing, or community engagement. These are real and must be addressed as quickly as possible by all response partners in support of the health authorities, including an urgent scale-up in areas outside of the urban centres.
The outbreak continues to spread, including in parts of Ituri and North Kivu where it likely remains undetected, as access, surveillance and testing are still major constraints.
Facilitating movement and access to affected areas will also be essential if the outbreak is to be brought under control.
In collaboration with the relevant health authorities, MSF teams work on case management and clinical care, surveillance support, community engagement, IPC, safe burial support, supply and equipment donations, training (IPC, isolation, case definition, etc.), and non-Ebola primary healthcare support. In DRC, MSF operates several ETCs and isolation units across Ituri, North Kivu and South Kivu provinces. In Uganda, MSF has rehabilitated an ETC near Kampala and also renovated an isolation centre located in south-western Uganda, bordering DRC. On 28 July, the Ugandan Ministry of Health declared the end of the Ebola outbreak; however, the WHO has not yet confirmed it.
Yes. Since MSF began providing care in Ituri, North Kivu, and South Kivu up to 25 July, 282 patients have survived and been discharged from its ETCs. There have also been some deaths, mostly among patients who arrived late at the treatment facility, when the disease is more advanced and more difficult to treat.
Over 1,400 MSF staff are responding directly to the Ebola outbreak in the DRC, working alongside Ministry of Health (MoH) teams. They are supported by more than 2,700 MSF staff, and nearly 4,500 incentivised MoH staff are already working in the country on existing health programmes, helping ensure that other essential health services continue. In Uganda, MSF has 20 staff responding to the outbreak.
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