Congo recebe 70 mil doses de vacina no surto de ebola mais letal de sua história

The International Vaccine Provision Coordination Group, a UN mechanism that manages emergency stockpiles, released 70,000 doses of the Ervebo vaccine to the Democratic Republic of Congo on Thursday (20). The country is facing the deadliest Ebola outbreak ever recorded on its territory: 5,021 confirmed cases and 2,325 deaths as of August 17, according to UN News.

The release came after a formal request from the Congolese government and was announced in a joint statement by the World Health Organization and the Africa CDC.

The coordination group brings together agencies that manage vaccine reserves for emergencies and decides who receives scarce batches when demand exceeds supply. It was this mechanism that approved the immediate shipment as soon as the Congolese request arrived, Euronews reported.

How will the doses be used?

The WHO detailed the distribution: 20,000 doses will go to a phase 3 clinical trial, designed to measure the vaccine's effect against the Bundibugyo virus, and 50,000 will be reserved for healthcare professionals and frontline workers, following the organization's current recommendations.

A vaccine approved for another virus.

Ervebo is licensed against the Zaire ebolavirus, the species responsible for major outbreaks in the last decade. The current outbreak is caused by Bundibugyo, a rarer species. The WHO itself acknowledges the uncertainty: "initial laboratory data and animal studies suggest that it may offer some protection," says the statement, without claiming proven efficacy. This is why a portion of the doses was set aside for research instead of direct vaccination.

On the page that compiles information about the outbreak, the organization is more direct: the Bundibugyo species is one "for which there is no vaccine or specific treatment, although work to test promising candidates is underway." Recruitment of patients for the first treatment trial began on July 2nd.

WHO Director-General Tedros Adhanom Ghebreyesus described the release as "an important example of global solidarity in action," in a statement reproduced by Euronews.

The deadliest outbreak in the country's history.

The WHO regional bulletin for Africa, with data finalized on August 16, describes the episode as the largest Ebola outbreak ever reported in the Democratic Republic of Congo, a country that has been dealing with the disease since the 1970s. Compared to the previous bulletin, there were 640 confirmed cases and 367 deaths.

The gross case fatality rate rose from 45.9% to 47.4% between the two reports, maintaining an upward trend observed for weeks. Euronews reported that in areas with limited response capacity, the rate reaches 70%.

In practice, almost half of those with a confirmed diagnosis have died: 2,325 deaths out of 5,021 cases as of August 17. The WHO bulletin for Africa also covers Uganda, a neighboring country where the disease was confirmed in May, along with Congo.

The speed that is worrying

In epidemiological week 30, the most recent one covered in the bulletin, the country recorded the highest weekly number of cases and deaths since the beginning: 567 and 296, respectively. Euronews compared the pace to that of the outbreak that hit West Africa between 2014 and 2016 and killed more than 11,000 people—the current one is advancing about three times faster.

Another sign cited by the WHO is the origin of the new diagnoses. Most appear in people who were not under monitoring, which indicates that transmission is ahead of contact tracing.

The disease has reached a sixth province.

The bulletin from August 16 confirmed the first case in the province of Bas-Uélé, in the northeast of the country, the sixth affected. The geographical expansion takes the outbreak away from its original focus in eastern Congo and broadens the area that teams need to cover.

The war that hinders the response.

The armed conflict between the Congolese government and the Rwandan-backed M23 militia has seriously compromised the work of health teams, according to UN News, which cites Ituri province as one of those affected. In combat zones, medical access is impossible, and each day without contact tracing lengthens the chain of transmission.

Healthcare professionals among the victims.

More than 160 healthcare workers have been infected, and 40 have died, UN News reported. This is the group that the WHO has placed at the top of the queue for the 50,000 doses intended for vaccination, precisely because they were exposed to the virus before any confirmed diagnosis.

What comes next?

The WHO confirmed the outbreak in May in the Democratic Republic of Congo and Uganda, and UN News records May 15 as the date of the declaration. The emergency committee of the International Health Regulations, which assesses whether the episode constitutes a public health emergency of international concern, met for the second time on August 18.

The next weekly WHO bulletins for Africa will show whether the doses arrive in time to change the curve or whether the phase 3 trial will only serve to answer, later on, whether Ervebo works against Bundibugyo.