WHO’s Ebola vaccination strategy ineffective in DRC: MSF

The aid agency has also called for an independent, international committee to manage Ebola vaccine stocks and their use   

By DTE Staff
Published: Tuesday 24 September 2019

International aid agency Médecins sans Frontiéres (MSF) has criticised the World Health Organization (WHO) for not providing Ebola vaccination to enough people in the Democratic Republic of the Congo (DRC), the Nature reported on September 23, 2019.

MSF (Doctors Without Borders) said the WHO is restricting both the availability of the vaccine in the field and the eligibility criteria for people to be vaccinated. Even frontline health workers remain under-vaccinated, as a result about 160 have been infected with the deadly virus in Beni — a city in the eastern DRC and a hotspot of the epidemic, the report said.

Ebola virus disease has infected more than 3,000 people in the DRC and claimed 2,108 people’s lives since the current outbreak, beginning late July 2018, according to the WHO.

While there is no proven treatment, the WHO has been administering the single dose ‘experimental’ vaccine rVSV-ZEBOV, produced by the pharma major Merck, to Ebola-afflicted patients in the DRC. The vaccine, which is still to gain a commercial licence, has an efficacy rate of 97 per cent, according to the WHO.

“We have a vaccine that is proven to be safe and effective; we have teams ready to be deployed; there is no problem with the cold chain; there are enough doses to cover the current needs,” said Isabelle Defourny, MSF director of operations, in a statement.

Yet, the WHO has distributed Ebola vaccine to “only a fraction of the eligible population” in the DRC, and “the pace of vaccination activities is too slow”, she noted. 

It has been recommended that for each confirmed Ebola patient, between 150 and 200 contacts should be vaccinated. With nearly 3,100 total confirmed cases reported so far, between 450,000 and 600,000 people should have been vaccinated, but only about 220,000 have recieved vaccinated, MSF said.

“... at least 2,000-2,500 people could be vaccinated each day, instead of 500 – 1,000 people as is currently the case,” Defourny said.

The aid group also called for an independent, international committee that will manage Ebola vaccine stocks and their use.

The criticisms came after WHO announced its plans to roll out the second vaccine, made by Johnson & Johnson, the Nature reported.

While the Merck vaccine will continue to be provided to all people at high risk of Ebola infection, the Johnson & Johnson will be administered to people in the eastern DRC who live in areas free of Ebola, the WHO said.  

“The Merck vaccine is highly efficacious, and we’ll soon have a second vaccine to increase the number of those being protected against the virus,” said WHO Director-General Tedros Adhanom Ghebreyesus.

Meanwhile, Ibrahima Socé Fall, the assistant director of WHO’s emergency response, has rejected MSF’s claims.

“MSF has overestimated the number of people who should be vaccinated. The aid group based its projection on the average number of contacts per person diagnosed with Ebola — but in many cases, the contacts of people with Ebola overlap. This reduces the overall number of people who need to be immunised against the virus,” Fall argued.

However, this strategy makes no sense because tracing contacts of people with Ebola has proven so difficult, said Nathalie Roberts, an emergency operations manager at MSF. Instead, in places where Ebola has spread for months people should be vaccinated broadly, she noted.

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