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A historic milestone has just been reached: preventive vaccination against the Ebola virus will be the norm in high-risk countries
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Gavi will also support low-income countries to implement routine administration of rabies vaccine for post-exposure prophylaxis, pentavalent meningococcal conjugate vaccine and hepatitis B vaccine at birth.
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Statement from Dr Sania Nishtar, Executive Director of Gavi: “As an Alliance, Gavi has the capacity to protect people’s health and save lives by making vaccines accessible to those who need it most, and as quickly as possible. The new programs launched today demonstrate the impact of this approach. Take, for example, Ebola virus disease. It is a terrible disease, which can devastate entire communities. Ten years ago, we had no vaccine to deal with a deadly epidemic. Today we have a global stockpile of vaccines that has helped reduce the number of cases and deaths – and now, these vaccines will even be administered as a preventative measure to protect those most at risk. »
Geneva, June 13, 2024 – Gavi, the Vaccine Alliance, today announced that low-income countries supported by Gavi can now apply for the introduction of four additional vaccines: Ebola vaccine for prevention, human rabies vaccine for post-exposure prophylaxis, pentavalent meningococcal conjugate vaccine, and hepatitis B vaccine for birth dose. These four vaccination programmes had previously been approved by the Gavi Board but were frozen: rabies vaccine for post-exposure prophylaxis and hepatitis B birth dose due to the COVID-19 pandemic; meningitis vaccine: pending the availability of the new pentavalent conjugate vaccine; and Ebola vaccine for prevention pending official recommendations.
This latest expansion of Gavi’s vaccine portfolio is in line with its commitment to ensuring low-income countries have rapid access to effective vaccines. The portfolio is expected to expand further during Gavi’s next strategic period (2026–2030), the objective of which will be to protect a greater number of people against a greater number of diseases, faster than ever. The continuation, after 2025, of all programs supported by Gavi will depend on the success of fundraising for the next strategic period of the Alliance.
Historic progress in the fight against Ebola
Gavi will begin funding preventive Ebola vaccination in countries at highest risk of the deadly viral disease, marking a historic milestone in global health security and the protection of health and frontline workers. This move was made possible by the decision last month by the World Health Organization’s Strategic Advisory Group of Experts on Immunization (SAGE) to formally recommend the use of the two licensed Ebola vaccines for prevention in frontline health and/or outbreak response workers who, due to their roles, are at high risk of exposure to the virus. This decision was made based on new evidence on the efficacy and duration of protection provided by the vaccines, and the stability of supply.
Gavi first committed to supporting Ebola vaccination in 2014, at the start of the deadly epidemic that raged in West Africa from 2014 to 2016: the Alliance facilitated the use of experimental doses in response to the epidemic and accelerated the prequalification process, then the creation, in 2021, of a global emergency stock. Funded by Gavi, this stock plays an important role in the response to epidemics. From now on, Gavi will also provide vaccines for preventive vaccination and will continue to provide funding for vaccination in low-income countries.
Ebola virus disease is a rare disease in humans, but it is a serious illness, with an average case fatality rate of around 60%, sometimes much higher depending on the outbreak response. However, the availability of safe and effective vaccines has enabled the number of cases and deaths in recent outbreaks to be significantly reduced and brought under rapid control. The additional support for preventive vaccination of those most at risk is all the more important as growing evidence indicates that new epidemics could break out, not only following transmission of the virus from infected animals, but also following the reappearance of the virus, years later, in patients who had survived the infection. Thanks to preventive vaccination, front-line healthcare workers will already be protected against infection and its dramatic consequences even before the start of epidemics, which will save lives and avoid the destabilization of health services, and thereby reducing the risk of infection spreading within communities.
“As an Alliance, Gavi has the power to protect people’s health and save lives by making vaccines available to those who need them most, as quickly as possible. The new programmes launched today are testament to the impact of this approach,” said the Dr Sania Nishtar, Executive Director of Gavi, the Vaccine Alliance. “Take, for example, Ebola. It’s a terrible disease that can devastate entire communities. Ten years ago, we had no vaccine to deal with a deadly outbreak. Today, we have a global stockpile of vaccines that have reduced cases and deaths – and now, these vaccines will even be given as a preventative measure to protect those who are most at risk.”
New tools to fight deadly infectious diseases
In July 2023, a new multivalent meningococcal conjugate vaccine protecting against the five major meningococcal meningitis serogroups in Africa – serogroups A, C, W, Y and X – has received WHO prequalification. It is the only vaccine providing protection against serogroup X. The MenFive® vaccine is available as part of the Gavi-funded global meningococcal vaccine stockpile. It has already been used in Nigeria and Niger, in vaccination campaigns aimed at protecting more than 5 million people in response to epidemics caused by serogroups C and W. With the opening today of the window for requests for grant, high-risk countries will be able to officially deploy this new vaccine as part of routine immunization programs and preventive vaccination campaigns.
Invasive meningococcal infections cause hearing loss, brain damage, seizures, amputations, disability and even death every year. They are particularly common in the 26-country “meningitis belt” of sub-Saharan Africa. For years, Gavi has worked with these countries to support vaccination against meningococcal serogroup A, reaching nearly 400 million people through vaccination campaigns and routine immunisation programmes. This is how Africa has successfully defeated meningitis A, with no new cases detected since 2017. With MenFive® in the arsenal of health systems, there is hope that one day we will be able to defeat other circulating serogroups.
Gavi’s 2018 Vaccine Investment Strategy (VIS) also identified Human rabies vaccines for post-exposure prophylaxis (PEP) as a high-impact vaccine to add to its portfolio. With its rollout delayed due to the COVID-19 pandemic, Gavi and its partners have been preparing since 2018 to launch the programme, which will provide rabies vaccines needed for post-exposure prophylaxis to Gavi-supported countries where rabies is endemic. Rabies is a serious public health problem in more than 150 countries, primarily in Asia and Africa. It causes tens of thousands of deaths each year, nearly half of which are in children aged 5 to 14 years. Once rabies has occurred, it is 100% fatal, meaning vaccination in high-risk areas is essential, especially as access to rabies immunoglobulin is severely restricted in most countries.
Similarly, Gavi’s 2018 Immunisation Investment Strategy recommended including theadministration of a dose of hepatitis B vaccine at birth in the Gavi portfolio. Supported countries already routinely vaccinate against hepatitis B using pentavalent or hexavalent vaccines, which are given to young children as part of the first round of vaccinations. But there is growing evidence that administering a dose at birth provides extremely important additional protection. Hepatitis B kills approximately 884,000 people each year. Newborns are most at risk; out of ten infected infants, nine will develop chronic hepatitis B, and a quarter of them will suffer from serious liver disease. Vaccination is essential because while the virus can be transmitted through bodily fluids, infants whose mothers carry the virus can become infected in the womb or during delivery. Children may be chronic carriers of a silent infection that becomes symptomatic when they reach the age of 40 to 50, and discover they have liver failure (the inflammation causing cirrhosis) or liver cancer.
