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Ebola in the DRC: For Jean-Jacques Muyembe, "a second vaccine is not our priority"
06 AUG 2019
Updated 06.08.2019 at 20:24 by
Jean-Luc Eyguesier
In the DRC, Professor Jean-Jacques Muyembe Tamfun has headed since the end of July 2019 the committee of experts responsible for the "national response" against the Ebola epidemic in the north-east, which recently won Goma. The co-discoverer of the Ebola virus does not rule out the use of a second vaccine, but explains today that "it is not the priority". Interview.
Uganda announced on Monday (August 5th) that it has begun testing an experimental Ebola vaccine that could be used in the neighboring Democratic Republic of Congo. In this country, the epidemic has killed more than 1,800 people in one year.
The trial of the MVA-BN vaccine produced by the Belgian laboratory Janssen, a subsidiary of the American Johnson & Johnson is expected to last two years, said the Council of Medical Research (MRC) of Uganda in a statement.
The subject is debated in the Democratic Republic of Congo, where the former Minister of Health was openly opposed to its use. He finally resigned on 22 July, feeling disavowed after appointing a committee of experts to oversee control of the Ebola response led by Professor Jean-Jacques Muyembe Tamfun, National Director of the Institute for Biomedical Research from Kinshasa.
He says he is much more in favor of this experimental vaccine even if for him, "it is not the priority". Since July, the epidemic has gained Goma, already two deaths in this major city in the east of the country.
TV5MONDE: There is much talk of using a second vaccine, developed by Johnson & Johnson Laboratories, to complement Merck's rVSV vaccine to fight the Ebola outbreak in eastern DRC. Has a decision been made?
Dr. Muyembe: For now, this is not our priority, we want to first control this epidemic that has arrived in a big city of the DRC (Goma), a hub for travelers. We still use the Merck rVSV vaccine. This second vaccine is a recommendation of the group of experts advising WHO on immunization and at its meeting on May 5, he suggested using it as a preventive vaccine.
In our research institute, we have studied several candidate vaccines and it turns out that the Johnson & Johnson vaccine is the one for which we have the most scientific data. In addition, it allows to provide the largest number of doses. So, at first glance, our choice fell on this vaccine, but it should be noted that it is a vaccine under study, not yet approved.
It is said that you personally support the use of this Johnson & Johnson vaccine. Is it true ?
Dr. Muyembe: I am the director of the National Institute of Biomedical Research and my team has studied it. It is not me who wants to impose a vaccine, but on the basis of scientific evidence, the team of researchers thought that this second vaccine could be used. Moreover, it is already used and tested in Guinea and now in Uganda.
What does it bring more than the Merck vaccine?
Dr. Muyembe: Its advantage is that it is preventive, like that of measles. The intention was to create a "curtain" of immunized people between the currently infected area in North Kivu and Goma. Geographically, there is a whole region between the two that is not affected by the epidemic and if we act there, we create a "belt" that stops the spread of the virus and thus we protect the city of Goma. It was the hypothesis.
This vaccine requires two injections 56 days apart, is this realistic in North Kivu conditions?
Dr. Muyembe: The problem is not the logistical effort. Moreover for the first vaccine, the "Merck", it was said that it would be impossible for cold chain issues among others, but we get there. At the Institute, we have the experience of vaccination against yellow fever ... All this is a question of methodology, communication with the population. If the population accepts, there is no problem.
What is even more important is to do some research. During this epidemic, we must do some research to find solutions for future epidemics. Not just for today's epidemic.
In your opinion, how do you convince the population that has often been hostile to caregivers?
Dr. Muyembe: Everyone is asking for a vaccine, and we know that with the first, the rVSV, we can not vaccinate a large population (for reasons of availability). Moreover, it proved its effectiveness while it was still in experimental form. It was during the Guinea epidemic in 2014, and we have confirmed it here in 2018, but we must continue the research.
As for the hostility of the populations, it is the weakness of our response whose communication is not anchored. We must strengthen it, get the commitment of the people. As long as we do not have this community commitment, it is unlikely that we will be able to successfully extinguish this epidemic.
...
Another problem is insecurity in the region.
Dr. Muyembe: Yes, that's even the main problem. That's why we say that the fight against Ebola is not just a public health problem. In our current strategy, we will include other responsible sectors. The problem of insecurity concerns the Ministry of the Interior, and then we have to integrate the Ministry of Defense to escort the teams, and still others...
You will go to Rwanda. What is the purpose of this meeting with the Rwandan authorities?
Dr. Muyembe: The disease is on our side and we must do everything to reassure the Rwandan authorities about the efforts we are making, how we control our borders. There will be meetings at the political and expert level. When the WHO Director General made this epidemic a public health emergency "of international concern", he added in his recommendations that there is no point in closing the borders to prevent displacement.
He urged neighboring countries not to choose this strategy, but rather to cooperate and be transparent. We need Rwanda and Rwanda needs the DRC.
Many countries in the region are worried. Are you worried about a regional extension of the epidemic?
Dr. Muyembe: If there is a risk of extension, it is more important inside the DRC than in neighboring countries, but we have teams that monitor travel and contacts to minimize the risk of spread to neighboring countries.
The President of the Republic entrusted you with the national coordination of the fight against the epidemic. What is your feeling about this load?
Dr. Muyembe: Three months ago, we said that we could control this epidemic in three months, given our experience in this area. Unfortunately, this appointment has just been made and the situation on the ground has completely changed.
Still, we remain confident and in three or four months we can stop this epidemic. The challenge is great and the responsibility is heavy, but we count a lot on the support of the population, the support of the civil society and our partners to carry out quality work.
Jean-Luc Eyguesier
Updated 06.08.2019 at 20:24
Ebola in the DRC: For Jean-Jacques Muyembe, "a second vaccine is not our priority"
06 AUG 2019
Updated 06.08.2019 at 20:24 by
Jean-Luc Eyguesier
In the DRC, Professor Jean-Jacques Muyembe Tamfun has headed since the end of July 2019 the committee of experts responsible for the "national response" against the Ebola epidemic in the north-east, which recently won Goma. The co-discoverer of the Ebola virus does not rule out the use of a second vaccine, but explains today that "it is not the priority". Interview.
Uganda announced on Monday (August 5th) that it has begun testing an experimental Ebola vaccine that could be used in the neighboring Democratic Republic of Congo. In this country, the epidemic has killed more than 1,800 people in one year.
The trial of the MVA-BN vaccine produced by the Belgian laboratory Janssen, a subsidiary of the American Johnson & Johnson is expected to last two years, said the Council of Medical Research (MRC) of Uganda in a statement.
The subject is debated in the Democratic Republic of Congo, where the former Minister of Health was openly opposed to its use. He finally resigned on 22 July, feeling disavowed after appointing a committee of experts to oversee control of the Ebola response led by Professor Jean-Jacques Muyembe Tamfun, National Director of the Institute for Biomedical Research from Kinshasa.
He says he is much more in favor of this experimental vaccine even if for him, "it is not the priority". Since July, the epidemic has gained Goma, already two deaths in this major city in the east of the country.
TV5MONDE: There is much talk of using a second vaccine, developed by Johnson & Johnson Laboratories, to complement Merck's rVSV vaccine to fight the Ebola outbreak in eastern DRC. Has a decision been made?
Dr. Muyembe: For now, this is not our priority, we want to first control this epidemic that has arrived in a big city of the DRC (Goma), a hub for travelers. We still use the Merck rVSV vaccine. This second vaccine is a recommendation of the group of experts advising WHO on immunization and at its meeting on May 5, he suggested using it as a preventive vaccine.
In our research institute, we have studied several candidate vaccines and it turns out that the Johnson & Johnson vaccine is the one for which we have the most scientific data. In addition, it allows to provide the largest number of doses. So, at first glance, our choice fell on this vaccine, but it should be noted that it is a vaccine under study, not yet approved.
It is said that you personally support the use of this Johnson & Johnson vaccine. Is it true ?
Dr. Muyembe: I am the director of the National Institute of Biomedical Research and my team has studied it. It is not me who wants to impose a vaccine, but on the basis of scientific evidence, the team of researchers thought that this second vaccine could be used. Moreover, it is already used and tested in Guinea and now in Uganda.
What does it bring more than the Merck vaccine?
Dr. Muyembe: Its advantage is that it is preventive, like that of measles. The intention was to create a "curtain" of immunized people between the currently infected area in North Kivu and Goma. Geographically, there is a whole region between the two that is not affected by the epidemic and if we act there, we create a "belt" that stops the spread of the virus and thus we protect the city of Goma. It was the hypothesis.
This vaccine requires two injections 56 days apart, is this realistic in North Kivu conditions?
Dr. Muyembe: The problem is not the logistical effort. Moreover for the first vaccine, the "Merck", it was said that it would be impossible for cold chain issues among others, but we get there. At the Institute, we have the experience of vaccination against yellow fever ... All this is a question of methodology, communication with the population. If the population accepts, there is no problem.
What is even more important is to do some research. During this epidemic, we must do some research to find solutions for future epidemics. Not just for today's epidemic.
In your opinion, how do you convince the population that has often been hostile to caregivers?
Dr. Muyembe: Everyone is asking for a vaccine, and we know that with the first, the rVSV, we can not vaccinate a large population (for reasons of availability). Moreover, it proved its effectiveness while it was still in experimental form. It was during the Guinea epidemic in 2014, and we have confirmed it here in 2018, but we must continue the research.
As for the hostility of the populations, it is the weakness of our response whose communication is not anchored. We must strengthen it, get the commitment of the people. As long as we do not have this community commitment, it is unlikely that we will be able to successfully extinguish this epidemic.
...
Another problem is insecurity in the region.
Dr. Muyembe: Yes, that's even the main problem. That's why we say that the fight against Ebola is not just a public health problem. In our current strategy, we will include other responsible sectors. The problem of insecurity concerns the Ministry of the Interior, and then we have to integrate the Ministry of Defense to escort the teams, and still others...
You will go to Rwanda. What is the purpose of this meeting with the Rwandan authorities?
Dr. Muyembe: The disease is on our side and we must do everything to reassure the Rwandan authorities about the efforts we are making, how we control our borders. There will be meetings at the political and expert level. When the WHO Director General made this epidemic a public health emergency "of international concern", he added in his recommendations that there is no point in closing the borders to prevent displacement.
He urged neighboring countries not to choose this strategy, but rather to cooperate and be transparent. We need Rwanda and Rwanda needs the DRC.
Many countries in the region are worried. Are you worried about a regional extension of the epidemic?
Dr. Muyembe: If there is a risk of extension, it is more important inside the DRC than in neighboring countries, but we have teams that monitor travel and contacts to minimize the risk of spread to neighboring countries.
The President of the Republic entrusted you with the national coordination of the fight against the epidemic. What is your feeling about this load?
Dr. Muyembe: Three months ago, we said that we could control this epidemic in three months, given our experience in this area. Unfortunately, this appointment has just been made and the situation on the ground has completely changed.
Still, we remain confident and in three or four months we can stop this epidemic. The challenge is great and the responsibility is heavy, but we count a lot on the support of the population, the support of the civil society and our partners to carry out quality work.
Jean-Luc Eyguesier
Updated 06.08.2019 at 20:24
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