Opinion: All for one and one for all

Developing an Ebola vaccine and rolling it out on a commercial scale are two very different challenges

Hilary Ayshford
Managing Editor

September saw the first healthy volunteers in the UK receive an experimental Ebola vaccine; further trials are due to begin in Africa in October. The vaccine is being developed by GSK and the US National Institutes of Health, and assuming that it produces a good immune response without serious side-effects, it could be available for use by the end of 2014.

But although this is remarkably fast compared with the snail’s pace at which new drugs usually progress through the approvals process, it will still be outpaced by the lightning speed at which the virus is spreading.

If the trials are successful, the next major challenge will be scaling up production. GSK has committed to making up to 10,000 doses of the vaccine, but in reality this will barely scratch the surface of what is needed. Manufacturing vaccines at high volumes requires significant investment and companies will want to be sure that there is a market for their products and that a reasonable return will be forthcoming.

Ripley Ballou, who heads the Ebola vaccine programme for GSK, puts the most optimistic timeline for 100,000 to 500,000 doses at nine months at a cost of US$$25m.

Then there is the question of logistics. Guinea, Liberia and Sierra Leone do not have a sophisticated healthcare infrastructure for distributing, storing and administering an extensive vaccination programme.

The World Bank has warned that the outbreak could have a catastrophic impact on the already-fragile economies of these countries. However, it says the cost can be limited if the epidemic is contained by a fast global response. Productivity has fallen as a result of quarantine measures and people are working, earning and spending less as a result, fuelling poverty.

The speed with which the new vaccines have reached the clinic is an example of how effective international co-operation can be. Scaling them up and getting them to the people who desperately need them will require a whole new level of global commitment.