Excitement and promise are the prevailing reactions to the interim results of the Ebola vaccine rVSV-ZEBOB (also known as the “Canadian vaccine”) trial. To date, the vaccine has proven 100% successful and shown to have few side effects, which particularly impressive for a live vaccine. In addition, it has been well tolerated.
As expected, many are enthusiastic. Jeremy Farrar, director of the Wellcome Trust, considers the vaccine “a remarkable result which shows the power of equitable international partnerships and flexibility.” It is a remarkable result indeed.
Ebola has exposed many vulnerabilities of how we deal with disease at the global level. The production of an Ebola vaccine demonstrates that where there is attention given by various sectors of society, science can and will receive sufficient support that otherwise would not have and what appear to be almost insurmountable scientific challenges can actually be overcome. What could have taken decades, took only 12 months.
The problem is that we function with a reactionary attitude. Social media played a critical role in exposing not only the gravity of the Ebola outbreak in West Africa, but also helped create the impetus to do something about it. It was an outbreak that the international community let go out of hand, and this became clear pretty quickly. Before we knew it, countries were mobilizing and creating hospitals, health care workers from all over the world were willing to risk their lives to make up for the scarcity of health care workers in the affected countries, funders were willing to invest in addressing public health infrastructures in these countries, and governments began to work with pharmaceutical companies to begin exploring the development of a vaccine against the disease as fast as possible.
In the grand scheme of things, however, there are many other public health threats that arguably deserve as much or even greater attention but because of their nature have not received the necessary spotlight. For example, tuberculosis is in dire need of new and effective drugs. The newest class of antibiotics to treat the disease was developed more than 40 years ago. Moreover, the side effects of existing drugs drive their patients to stop treatment and drug resistance is a serious and concerning problem. Neglected tropical diseases (NTDs) (like dengue fever), which affect the world’s poorest people, are likewise a clear example. According to the CDC, six of the infections caused by NTDs “can be controlled or even eliminated through mass administration of safe and effective medicines …, or other, effective interventions.”
“In union there is strength” wrote the ancient Greek fabulist Aesop, and this is one of the many lessons learned (or that should be learned) from the recent Ebola outbreak as we look to address current and future global health challenges. The editorial in The Lancet recognizes this and correctly states: “One important message goes beyond even Ebola—the power of multilateralism and inclusive partnership to devise and execute critical clinical research. Ebola has been a catastrophe for west Africa. But out of this epidemic has come the opportunity to build unprecedented collaborations to generate evidence to advance health. There have been few better examples to prove the value and importance of WHO to strengthen global health security.”
Now, whether we actually take the lesson to heart and change our ways is a different story.