One of the world’s biggest aid agencies is accusing the World Health Organization of restricting the use of a Canadian-developed Ebola vaccine that has proven highly effective in preventing the transmission of the deadly virus.
More than 2,100 people have died in the current Ebola epidemic in eastern regions of the Democratic Republic of the Congo (DRC), the second-worst Ebola outbreak in history. After more than a year, the epidemic is showing no signs of ending, and cases have spread to neighbouring Uganda.
Médecins sans frontières (MSF, or Doctors Without Borders) says the experimental vaccine should be administered to 2,000 to 2,500 people a day in the DRC, more than twice the current rate of 500 to 1,000. It says there is a “lack of transparency” in the WHO’s vaccination decisions and says the UN agency is imposing “strict limits” on the number of doses in the field.
In response, the WHO said Monday that it is providing as much as it can.
MSF has vaccination teams in the epidemic zone, but it says they are often forced to remain on standby, waiting for a handful of doses reserved for people on a predetermined list.
“Every day we see known contacts of confirmed Ebola patients who have not received their dose, despite being eligible for vaccination,” MSF emergency co-ordinator Natalie Roberts said in a statement Monday.
“Our capacity to carry out real-time assessments and react accordingly is severely undermined by a rigid system, which is hard to comprehend. It’s like giving firefighters a bucket of water to put out a fire but only allowing them to use one cup of water a day.”
The Ebola vaccine, developed at Winnipeg’s microbiology laboratory and now produced by Merck, was found to be effective in a clinical trial in Guinea in 2015 near the end of the worst Ebola epidemic on record, which killed more than 11,300 people in West Africa.
During the latest outbreak, in the DRC, the vaccine has demonstrated a 97.5-per-cent protection rate, according to WHO data.
More than 223,000 people have received it so far, and Merck has told MSF that it is ready to ship another 190,000 doses if required, along with 650,000 doses in the longer term.
But MSF says its vaccination work has been “frustrated by tight controls on supply and eligibility criteria imposed by WHO.” In some hot spots, almost a third of front-line health workers have not been vaccinated, it said.
“How can we expect the Congolese people to trust a system that is not even transparent to front-line health workers like MSF?” Dr. Roberts asked.
The aid agency is calling for the urgent creation of an independent co-ordination committee to provide more transparent management of the Ebola vaccination program.
A senior WHO official denied that the agency is restricting access to the vaccine.
“We partner closely with the DRC government to reach as many communities and individuals in the outbreak area as possible,” Mike Ryan, executive director of the WHO’s health emergencies program, said in a statement Monday.
The vaccination strategy is based on recommendations from an independent advisory body of experts and is approved by the DRC government and other partners, he said.
Dr. Ryan confirmed that another experimental Ebola vaccine, manufactured by Johnson & Johnson, will be introduced in the outbreak region in mid-October “as an additional tool to extend protection against the virus.” It will be administered to “targeted at-risk populations in areas that do not have active Ebola transmission.”
In recent weeks, the spread of the virus seems to have ebbed slightly, but the death rate remains as high as it was in the epidemic in West Africa, despite the new vaccine and treatment options, MSF said.
“Some areas have been active hot spots for over a year now, and other hot spots have become active again, after extended periods without reporting new cases,” it said.
From Sept. 11 to 17, according to the latest WHO situation report, there were 57 new confirmed cases of Ebola in eastern DRC, compared with 40 cases the previous week.
The epidemic has sparked international concern because it is located near the borders of several other countries.
This weekend, the WHO issued an unusual statement of concern about possible unreported cases in Tanzania. It said Tanzanian authorities took too long to respond to the WHO’s urgent request for information and had failed to share samples of tests on a possible Ebola patient and two of her contacts. As such, the tests cannot be verified by an outside laboratory.
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