Evening Ebola Update, Sun, 1/25: Dr. Chan tells WHO her priorities re: EBOV/WHO/Vaccine trials have different designs in each West African country   Leave a comment

1/25/15

Dear Colleagues:

l.  Reuters has an article on what needs to change at WHO to make WHO more rapid and more effective in global health emergencies.  The article quotes speakers at the WHO Executive Board’s Special Meeting on Ebola today who said that regional WHO directors made the EBOV epidemic political rather than a medical emergency and WHO responded too slowly with too little power to end the EBOV epidemic while it was an outbreak.  See: http://www.reuters.com/article/2015/01/25/us-health-ebola-who-idUSKBN0KY0KA20150125

2.  WHO website has posted Dr. Chan’s opening speech to the WHO Executive Board’s Special Meeting on Ebola today.  The most important statements from Dr. Chan’s speech are:  WHO has set up 27 laboratories in West Africa; deployed 60 Ebola health care teams in West Africa; established 66 Ebola Treatment Centers in West Africa; sent a total of 2000 HCW to West Africa.  There are now WHO officials in all prefectures and districts of Liberia, Guinea, and Sierra Leone.

3.  Dr. Chan states her most important goals now re: EBOV are: restoring and upgrading health care systems in West Africa so all countries are prepared to stop a subsequent outbreak of zoonotic infectious disease in its tracks; implement new ways to get medicines and drugs to market sooner; develop a ‘rapid response teams’ for WHO to immediately respond to global health emergencies; setting up a contingency fund to cover expenses of ‘rapid response teams’.  See the entire Dr. Chan speech at: http://who.int/dg/speeches/2015/executive-board-ebola/en/

4.  Many news sites on the world-wide web have reported that several Ebola vaccine Phase 3 trials will begin in West Africa within weeks.  An article by Martin Enserink in Science 16 January on page 219-220 describes the methodology of these various trials.  The debate over randomized controlled trials versus ‘compassionate use’ distribution of vaccine has been ‘solved’ by using different trial methodology in Liberia, Guinea, and Sierra Leone.  Here is a modified chart from Enserink’s article:

1. Liberian trials:  Led by: NIH; Participants: 30,000; Design: Randomized trial with control arm in general population. Vaccines: GSK, Merck.

2.  Guinean trials:  Led by: International consortium; Participants: 9000; Design: 1. Ring vaccination, 2. Observational study in EBOV HCW; Vaccines: To be determined.

3.  Sierra Leone trials:  Led by: CDC; Participants: 6000; Design: Stepped-wedge trial in EBOV HCW; Vaccines; To be determined.

See the Enserink artlice and chart at: http://www.sciencemag.org/content/347/6219/219.full

RGL, MD

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Posted January 25, 2015 by levittrg in Ebola, HAI

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