Guinea

PHARMACEUTICAL PROCESSING by  Princeton University, Woodrow Wilson School of Public and International Affairs   Aug. 6, 2015

Ebola is a preventable disease, and yet a safe and effective vaccine has not been deployed. As with many vaccines, financial barriers persist: pharmaceutical companies see high costs with limited market potential, and government support is lacking. But there may be a solution to this vaccine crisis with the ability to save at-risk populations, according to a perspective piece written by physicians based at Princeton University, University of Pennsylvania and the Wellcome Trust.

The article, published in the New England Journal of Medicine, proposes the creation of a $2 billion global vaccine-development fund - supported by governments, foundations and pharmaceutical companies - that would carry promising vaccines through development to deployment. With initial support, the global vaccine fund could help make vaccines available for emergency use.

Analysis
WIRED.COM by Katie M. Palmer                                                            Aug. 4, 2015

Last week, the medical journal the Lancet published preliminary results on the efficacy of an Ebola vaccine in Guinea, and everybody got really excited—especially about one particular figure. The vaccine, the results suggested, was 100 percent effective at protecting against Ebola, a thrilling prospect in the face of an epidemic that has killed more than 11,000 people. ...

But that number probably means less than you think it does. It’s based on incomplete data, so it doesn’t have the statistical clout it should. And it never will. Based on the vaccine’s early success, the trial’s runners decided that all participants in the study should get it immediately after exposure. That’s a perfectly reasonable, humane reaction, but it also means that the researchers will never be able to collect better data on the vaccine’s efficacy, which is what regulators look for when they’re deciding to approve a drug. In other words, the vaccine’s early success could make it harder for people to get it down the line.

ASSOCIATED PRESS by MARIA CHENG and RAPHAEL SATTER   July 31, 2015

LONDON — The United Nations Mission for Ebola Emergency Response is officially winding down Friday, handing its leadership role and senior staff to the Geneva-based World Health Organization as efforts to contain the deadly virus continue.

"We have reached an important milestone in the global Ebola response," U.N. Secretary-General Ban Ki-moon said in a statement Friday, while noting that that crisis "is not yet over."

The Ebola mission, also called UNMEER, was established last year as WHO struggled to get a handle on an outbreak that has killed more than 11,000 people, mainly in Guinea, Sierra Leone and Liberia. WHO had been strongly criticized for fumbling its response to the epidemic, and the creation of UNMEER was widely seen as a rebuke to its leadership.

Speaking to reporters Friday, UNMEER chief David Nabarro said he had seen signs that WHO had already absorbed some of the lessons of the Ebola disaster, recovering its coordination role in West Africa and deploying more 1,000 staffers to the field.

Read complete story.
http://www.seattlepi.com/news/medical/article/WHO-works-to-reform-itself-after-fumbling-Ebola-6416880.php

PLOS/Medicine   by  Tom H. Boyles                            July 28, 2015

The mortality rate for patients with Ebola virus disease (EVD) in West Africa is approximately 65% [1]. There are no published figures for high-resource settings, but media sources and individual case reports suggest it is much lower and approaches 0% for those who receive this level of care from the beginning of their illness.

In their article “Ebola Viral Disease: Experience and Decision Making for the First Cases outside of Africa,” David Stephens and colleagues give insight into the care that can be provided when available resources are not the limiting factor [2]. They describe the decision to open the Serious Communicable Diseases Unit (SCDU) of Emory University Hospital (EUH) when two United States patients contracted EVD while working in West Africa. Using a large specialist team, they provided high-quality care in a safe working environment and disseminated their knowledge and experience widely.....