The Health Authority of the Democratic Republic of Congo (DRC) said in the past week that it will allow a new vaccine that is developed by drugs company Johnson & Johnson to be used to contain the second ever largest outbreak of Ebola. The current vaccine in use, developed by Merck, is in limited supply, with only 500,000 units remaining; the BBC reports that it is therefore only being given to those who might have come in direct contact with someone known to have Ebola, and to health workers in the field. The new vaccine caused controversy, with former Health Minister Oly Ilunga questioning its effectiveness, in July of this year. He later resigned after having his control over the prevention of Ebola stripped from him.
The current health response team of the DRC government made a statement to Reuters, pointing out that “it is a vaccine that other countries already use. Why can’t we use it in Congo to protect our population?” Professor Peter Piot, an expert of Ebola, and Director of the London School of Hygiene and Tropical Medicine, said the new vaccine “has shown outstanding safety” and called for its deployment. The World Health Organisation also has asked for an increase in Ebola prevention, in August calling on states and NGOs to “increase their presence in the field to stop Ebola and to address one of the largest and most complex humanitarian crises in the world”.
The new vaccine cannot come soon enough to the DRC. With Ebola being such an infectious disease, containing it has to be the absolute priority, and the Johnson & Johnson drug can do just that. Over 180,000 people have been vaccinated in the twelve months since the outbreak began, but the rate of new cases per week is increasing, with 40 reported cases the week before 17 September 2019, and 57 the following week. Whilst the Merck drug is highly effective, with a 97.5% success rate, there simply is not enough of it reach the herd immunization necessary to end the epidemic.
Johnson and Johnson claim to have 1.5 million vaccines ready for immediate deployment. Over 2100 people in the country have already died from Ebola just in this current epidemic, with a total of 3000 reported cases. There are currently 10 million people in the two most at-risk provinces in North-Eastern DRC. The current plan is therefore to create a large-scale ring of immunized people around the most exposed areas, to function as a buffer of immunized people and contain the epidemic. This plan could only go ahead with enough vaccines available, however. There has also been a tightening of the North-Eastern border with Rwanda, but with more vaccinations, there could be greater effectiveness and more travel allowed.
Looking forward, accompanying the introduction of the Johnson & Johnson drug needs to be an increase of education and trust between outside health workers, drug companies and local populations. The Lancet medical journal reports that 36% of DRC residents thought that Ebola was a hoax designed to “destabilize the country”, with the population still mistrusting authority, following the Great African War earlier this century. Al Jazeera has reported multiple attacks on health centres, one of which ended in the death of a health worker. Not only is this tragic, but it leads to less effective treatment for a lethal disease, as vaccinations cannot be administered, and cases cannot be reported. To improve health outcomes, there must be more vaccines, education, and trust.