Read on Twitter
1/ Good news. There's now an international stockpile of #Ebola vaccines. It is managed by the ICG group, under auspices of @WHO. @MSF is a member of this group.
Good news, but sometimes the devil is in the details and some of details of the announcement are no so great IMO.
https://twitter.com/UNICEF/status/1348800624633245699
Good news, but sometimes the devil is in the details and some of details of the announcement are no so great IMO.
https://twitter.com/UNICEF/status/1348800624633245699
2/ First the good news.
The ICG is committed to ship doses to countries in need within 7 days after a request is sent.
The stockpile is primarily meant to vaccinate communities amidst outbreaks, not to provide vaccines during inter-epidemic times.
The ICG is committed to ship doses to countries in need within 7 days after a request is sent.
The stockpile is primarily meant to vaccinate communities amidst outbreaks, not to provide vaccines during inter-epidemic times.
3/ The only vaccine that is part of this stockpile is #Ervebo (aka rVSV-EBOV), marketed by @Merck. It is a very efficacious vaccine, but its main drawback is the requirement for an ultra-cold chain (storage at -70°C, then no more than 2 weeks at 2-8°C when deployed).
4/ The other licensed Ebola vaccine (Zabdeno/Mvabea, aka Ad26.ZEBOV/MVA-BN-Filo marketed by @JNJNews) is not part of this agreement. J&Jâs vaccine requires two doses 56 days apart, so not optimal for reactive vaccination during outbreaks.
5/ Now the problematic bits.
The target size of the ICG/WHO stockpile is 500,000 doses, but it will actually take many months before this target is reached. Only 6,890 doses are available in January 2021. No more than that. I hope no Ebola outbreak will start in coming monthsâŠ
The target size of the ICG/WHO stockpile is 500,000 doses, but it will actually take many months before this target is reached. Only 6,890 doses are available in January 2021. No more than that. I hope no Ebola outbreak will start in coming monthsâŠ
6/ Why is supply limited? Maybe Merck still struggles to ramp up production? Itâs been like that for years now⊠In 2019, short supplies led WHO to recommend fractional doses of vaccine. https://www.sciencemag.org/news/2019/05/drc-expands-ebola-vaccine-campaign-cases-mount-rapidly
7/ Please also remember there is another customer to satisfy (e.g. the US Strategic National Stockpile @BARDA). I havenât been able to find how many doses were allocated to ICG/WHO vs BARDA/SNS. It would be great to clarify it.
8/ Over last years, BARDA has actually donated doses to gov of DRC to control outbreaks. I am hopeful this collaborative spirit will continue, if ever there weren't enough doses in ICG/WHO stockpile to contain an on-going outbreak.
9/ Now letâs speak about 
. The vaccine doses stockpiled by ICG are paid by @gavi. This funding stems from an overall budget of $178million for Ebola for 2020-2025. Thanks GAVI. However, the price per dose (not mentioned in the Unicef press release) is very high: US$98.60 !
. The vaccine doses stockpiled by ICG are paid by @gavi. This funding stems from an overall budget of $178million for Ebola for 2020-2025. Thanks GAVI. However, the price per dose (not mentioned in the Unicef press release) is very high: US$98.60 !
10/ I canât find a clear justification for this high price. It is true that the number of doses that will be produced annually is pretty low, hence the limited economies of scale. But $98, come on!
11/ Development of Ervebo has been heavily supported by not-for-profit foundations & public sector, particularly in Canada & US. So only an arguably small portion of the R&D costs for this vaccine was actually paid by Merck themselves! https://academic.oup.com/jlb/advance-article/doi/10.1093/jlb/lsz019/5706941
12/ I donât even want to speak about NewLink, the tiny biotech company based in the US that acquired the license for the vaccine from @GovCanHealth in 2010 for just $200,000...
13/ ...NewLink didn't do anything for the development of the vaccine and finally sold the license for $50million (!) to Merck in 2014, whilst the West African Ebola outbreak was raging⊠That's what I call "profiteering"⊠https://www.cbc.ca/news/health/canadian-ebola-vaccine-development-taken-over-by-merck-1.2847128
