Gavi statement on the Ebola disease outbreak in Democratic Republic of the Congo and Uganda

Gavi, the Vaccine Alliance is closely monitoring the Ebola disease outbreak caused by Bundibugyo virus that is currently affecting the Democratic Republic of the Congo (DRC) and Uganda, and which the WHO Director-General has declared a Public Health Emergency of International Concern (PHEIC) and the Africa Centres for Disease Control and Prevention (Africa CDC) have declared a Public Health Emergency of Continental Security (PHECS). 

More than 500 suspected cases and over 130 deaths have been reported in DRC, with confirmed cases in Kampala, Uganda, highlighting cross-border spread and a rapidly evolving situation. With no licensed vaccines or therapeutics available and transmission amidst a mobile, conflict-affected and hard to reach population, this Bundibugyo virus disease (BVD) outbreak is deeply concerning, both for the countries and communities directly affected as well as for global health security. It requires a country-led, highly-coordinated, and evidence-based response. 

As the global vaccine Alliance, Gavi is actively coordinating with the Coalition for Epidemic Preparedness Innovations (CEPI), WHO, Africa CDC, UNICEF, World Bank, Pandemic Fund, and other partners as well as the affected countries to assess needs and define how best we can both support outbreak response efforts and help countries safeguard essential public health services such as routine immunisation. 

Use of vaccines in outbreak response 

There are currently no licensed vaccines for BVD. Gavi funds the global stockpile of Ebola vaccines, which are licensed for use against Zaire ebolavirus – a different species than Bundibugyo virus. Considering the extremely limited available evidence on cross-protection against non-Zaire species, any decision to use this vaccine in the current BVD outbreak will require further assessments and will occur in accordance with WHO guidance, and only with the explicit informed consent and understanding of affected communities that the benefit of the vaccine against BVD is currently unknown.

Gavi is also working with CEPI – with whom we have an established coordination agreement for such situations – and other partners, including the private sector, to assess the suitability and feasibility of various candidate vaccines currently in the research and development (R&D) pipeline, including how R&D could be accelerated to support outbreak response. This pipeline includes two candidates highlighted by WHO: 

A candidate vaccine leveraging rVSV platform (the same platform as the licensed vaccine against Zaire ebolavirus, Ervebo) but targeted towards Bundibugyo ebolavirus. However, there are no doses of this candidate available for clinical trials and current estimates are that producing doses for clinical trials could take 6-9 months. 

A candidate vaccine leveraging the ChAdOx platform (used for licensed COVID-19 vaccines) and targeted towards Bundibugyo virus. However, there are no animal or human studies for this vaccine and no data on its use against BVD. 

Availability of Gavi support 

Based on these on-going conversations, Gavi is also assessing how its First Response Fund (FRF) could be leveraged in the context of this outbreak. 

The result of learnings from the COVID-19 pandemic, the FRF was approved by the Gavi Board primarily to facilitate rapid access to vaccines outside Gavi’s portfolio – including through at-risk procurement and market shaping tools such as Advanced Purchase Commitments – during a public health emergency. In the current context, these tools will be used to incentivize manufacture of promising vaccine candidates, adhering strictly to an evidence-based approach and ensuring doses are produced as quickly as possible. The FRF and other Gavi mechanisms could also be used for targeted deployment of resources to protect routine vaccination and support immunisation-related health systems strengthening efforts. The FRF was used during the recent mpox emergency to secure 500,000 doses and to support outbreak response and efforts to protect routine immunisation services – through almost US$10 million delivery support funding provided by Gavi. 

The FRF provides a total of $500 million for all qualifying emergencies through 2030. A use of up to US$50 million is at the discretion of the Gavi Chief Executive Officer to facilitate rapid response, and if more resources are needed, such use would be subject to approval by the Gavi Board. 

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