Global Health Ebola Update 1/22

EBOLA

GHN Exclusive: Tolbert Nyenswah - Part II

Tolbert Nyenswah, Liberia’s National Ebola Incident Manager and Assistant Minister/Deputy Chief of the Ministry of Health & Social Welfare, continues his talk with Dayna Kerecman Myers.

Q. You’ve been working with colleagues at Johns Hopkins to connect to drug manufacturers for experimental treatments and vaccines. How is that going?
In the past months we’ve been working to reach consensus regarding protocol, ethics and regulation. Phase 1 data from studies conducted in the US, Europe and sub-Saharan Africa shared with the Liberian Technical and Consultative Advisory Groups clearly indicated promising immunogenic responses. [This] led to a proposal to combine the Phase II/III approach in Liberia. Now, Liberia-US Technical Teams are finalizing protocols to submit to ethical and regulatory entities for approval, recruiting and hiring hundreds of Liberians to support the project structure, rehabilitating designated health centers, upgrading lab facilities, developing a clinical research program at the Liberian Institutes for Biomedical Research (LIBR), and providing mentoring and training opportunities to Liberians. Discussions are underway to ensure acceptable liability insurance for Liberian investigators and study volunteers, and the government is developing a legal framework.

Q. Could the (thankfully) dwindling number of cases in Liberia make it harder to prove the efficacy of the vaccine?
Vaccine trials are still set for implementation. The Official Launch of the EVD vaccine trial is expected to commence by the end of January or early February, at either JFK or Redemption Hospital. A reduction in the cases could be a challenge for the vaccine trial, but will not necessarily affect the quality of the study.

Q. Earlier you mentioned that you'd like to see the use of cell phone data and geo-spatial mapping to better understand patterns and boost the government response. Are you seeing that yet?
We’ve been working with partners on several technology-driven initiatives. For example, the CDC analyzed cell phone tower traffic in Liberia to pinpoint potential outbreaks (where clusters of people called the national Call Center), and to gauge the effectiveness of social mobilization campaigns. UNMEER/UNFPA are equipping contact tracers with close to 3,000 mobile phones. And the US National Geospatial Intelligence Agency (NGA) has compiled ** data through geospatial mapping (http://jhsph.us3.list-manage.com/track/click?u=0a43ad874dbe00d8f0545cfef&id=66207350fc&e=9c1fcebfa3)
, placed online to boost the international response to Ebola. We’re confident that many of these initiatives will last beyond the EVD response, and will support the broader health system as we continue to rebuild essential health services.

Vaccine Challenges
Though the global focus on Ebola is fading, the disease still looms large in the global health community, and prevention of the next epidemic is a top priority.

Central to the effort is the development of an Ebola vaccine, the subject of a piece in The Lancet that proposes 7 key challenges to consider early in the process.

Among the questions raised by international vaccine experts: Who will be vaccinated? How will a vaccine reach the target populations? How safe does the vaccine need to be?
** The Lancet (http://jhsph.us3.list-manage.com/track/click?u=0a43ad874dbe00d8f0545cfef&id=022a2dc93e&e=9c1fcebfa3(14)62398-9.pdf)