Experts assembled by WHO advise on possible treatments and vaccines for Ebola caused by the Bundibugyo virus

Key recommendations

There are currently no licensed therapeutics or vaccines specifically approved for the prevention and treatment of BVD. However, WHO advisory groups have considered several candidate products that are sufficiently promising to warrant prioritization for evaluation in clinical trials. WHO is now working closely with the governments of the Democratic Republic of the Congo and Uganda to facilitate the implementation of research evaluations of these products.

To treat cases:

• For treatmentindependent experts recommended prioritizing three therapeutic candidates for investigational evaluation (ie, clinical trials) among confirmed cases of BVD: monoclonal antibodies MBP134 and Maftivimab®as well as antivirus remdesivir.
• Combination therapy using a monoclonal antibody and remdesivir is also recommended for evaluation.

To prevent cases:

• For prophylaxis after exposure among contacts of confirmed and probable cases, an oral antiviral drug obeldesivir has been identified as a priority candidate, although experts have noted that this approach depends on effective contact tracing, which remains operationally challenging in some of the affected areas of the Democratic Republic of Congo. Post-exposure prophylaxis research involves giving obeldesivir tablets to contacts of sick people to see if it prevents them from developing Ebola.
• The most promising candidate vaccine experts have determined that it is a single dose rVSV Bundibugyo vaccine (developed by the International AIDS Vaccine Initiative or IAVI). This single-dose vaccine candidate will likely take 7-9 months to develop before it is ready to be evaluated for its ability to prevent BDV through a clinical trial.
• More candidate vaccine, ChAdOx1 Bundibugyo (being developed by the University of Oxford/Serum Institute of India) could potentially become available within 2-3 months to assess efficacy through a clinical trial. However, additional animal data are still needed to support and validate further prioritization. Experts noted that the candidate’s single-dose vaccine approach may be appropriate for contacts of Ebola cases, while a two-dose strategy could be considered for high-risk but unexposed populations such as healthcare workers and frontline responders.
• The assembled experts also considered the potential role Ervebothe only licensed Ebola vaccine. It is approved for use during epidemics caused by the most common Ebola virus in Africa, from Orthoebolavirus family. Ervebo is not licensed for the prevention of BVD and evidence of cross-protection with other types of Ebola virus remains limited and inconclusive. WHO recommends that Ervebo should not be used outside of carefully designed research settings, to allow evaluation of its efficacy against BDV.

Ensuring ethical and safe clinical trials

WHO, the governments of the Democratic Republic of the Congo and Uganda, the African Centers for Disease Control and Prevention (Africa CDC), ANRS for Emerging Infectious Diseases (French National Agency for Research on AIDS and Viral Hepatitis) and other scientific partners are working together to develop and implement appropriate protocols to assess the safety and efficacy of priority therapies through clinical trials in the field.

WHO calls for accelerated access to essential supplies, stronger community protection, engagement and trust, and coordinated investment in research, development and evaluation of BVD countermeasures.

All research must adhere to the highest ethical standards, under the guidance of national health authorities and in close collaboration with affected communities.

In the meantime, our priority is to stop transmission using the tools we’ve used for decades to fight Ebola, which include disease surveillance, rapid testing and diagnosis, contact tracing, patient isolation and care, infection prevention and control, community engagement, and safe and dignified burials.

Background

The WHO R&D Blueprint is a global initiative that enables rapid activation of research and development activities during epidemics. Its goal is to accelerate the availability of proven effective tests, vaccines and drugs that can be used to save lives and prevent large-scale crises.

SAGE is the WHO’s main advisory group on vaccines and immunization. He is responsible for advising WHO on overall global policies and strategies, ranging from vaccines and technology, research and development, to immunization implementation and its linkages with other health interventions.

ABOUT WHO

Committed to the well-being of all people and guided by science, the World Health Organization leads and supports global efforts to give everyone, everywhere, an equal opportunity to live a safe and healthy life.

We are the UN health agency that connects nations, partners and people on the front lines in more than 150 locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health problems and expanding access to medicines and healthcare. Our mission is to promote health, keep the world safe and serve the vulnerable.