Day: May 22, 2018

Preparations are under way for a mass Ebola vaccination campaign in the Democratic Republic of Congo as the Ministry of Health and international aid agencies hold a second day of inoculations in northwestern Equateur Province. The latest World Health Organization estimates report 51 cases of Ebola, including 27 deaths.

The World Health Organization said 33 people, most of them front-line health care workers, were vaccinated against Ebola on Monday in Mbandaka, a city of more than one million people. It said a few high-risk people from the community also were vaccinated during the first day of the campaign.

More than 7,500 doses of the Ebola vaccine have been shipped to the Democratic Republic of Congo. WHO spokesman Tarik Jasarevic told VOA he expects the campaign to accelerate and ultimately reach thousands of people.

He said a lot of work has to be done before this complex operation can hit its stride. For example, he said transporting the vaccines and storing them in freezers in affected areas is a major challenge.

“You need to have vaccination teams to be trained so they know exactly what they need to do, how to get a consent, how to define eligibility of a contact and contacts of contacts,” he added. “So, all of that has to be done in a very, very short period of time under very difficult conditions.”

Jasarevic said a team from Doctors Without Borders will begin vaccinations later in the week in Bikoro, the remote rural town in northwestern Equateur Province, where the deadly Ebola virus was discovered two weeks ago.

The Ebola vaccine is not licensed, but a major trial in 2015 in Guinea showed it gave a high rate of protection against the disease. A so-called ring vaccination strategy is being applied. It relies on tracing all the contacts and extended contacts of a recently confirmed case as soon as possible. More than 600 contacts have been identified.
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The Ebola outbreak that has killed more than two dozen people in northeastern Democratic Republic of Congo could be as devastating as the one that hit West Africa several years ago, if left unchecked.

But first responders say things are different this time. That’s in large part thanks to a vaccine they couldn’t use in late 2013, when Ebola cases were first reported in Guinea.

The pharmaceutical giant Merck has shipped about 8,600 doses of its experimental vaccine, V920, to the site of the outbreak in Equateur province. The drug has gone through Phase 3 trials, but has not yet received regulatory licensure in any country.

It will be administered in Congo by the World Health Organization, a Merck spokesperson told VOA.

‘Ring vaccination’

Having an effective vaccine isn’t enough, the head of policy and health diplomacy at the Africa Centres for Disease Control and Prevention, Dr. Benjamin Djoudalbaye, told VOA by phone from Geneva.

V920 isn’t designed for mass vaccination. People who have come in contact with a patient must be identified and given the drug.

“But the difficult part,” Djoudalbaye said, “is to properly list down all the contacts and press them in such a way that they (understand they) can benefit from the vaccine and it will stop the spread of the disease.”

The WHO will follow the “ring vaccination” approach, wherein anyone who has come into contact or may come into contact with an infected person is vaccinated to contain the threat.  This could include family members, funeral workers, health workers and others in close contact with a patient.

So far, V920 has prevented everyone vaccinated from contracting the virus. In a 2015 trial, none of the 5,837 people who received the vaccine became sick.

A Merck spokesperson said in an email that the company plans to file for licensure in 2019, but it has made the vaccine available due to the Congo outbreak.

The WHO has requested an additional 8,000 doses, and Merck said it is working to fulfill that request.

Spread to neighboring countries?

On May 18, the East African Community regional bloc warned its members that the virus could potentially spread from the DRC due to direct flights between the countries and extensive trade relations.

“Five out of six EAC partner states share borders with the DRC, and all of them maintain close trade relations with high border traffic,” the statement alerted.

The WHO has not declared a state of emergency, and travel to and from the DRC has not been restricted.

But Djoudalbaye, who just returned from the DRC, said there are no sure things in disease control. It’s just a matter of lowering the risk as much as possible. “The risk ‘zero’ doesn’t exist,” he said, “That is what we need to have all keep in mind.” But strong action from the government can limit the disease from spreading, he added.

Djoudalbaye says health officials, NGOs and governments learned many lessons from the West Africa Ebola outbreak in 2014 and 2015, including the importance of a health-response infrastructure to support rapid intervention.

Key to that effort has been the Africa Centres for Disease Control and Prevention, which opened in early 2017.

Existing systems and earmarked resources have enabled a speedy response in the DRC, Djoudalbaye said. “After the declaration of the Ebola outbreak in DR Congo on the eighth (of May), by the tenth, we were on the ground.”

V920 isn’t new. A team of scientists led by University of Manitoba researchers Steven M. Jones and Heinz Feldmann invented the vaccine in 2003 at the Public Health Agency of Canada, in Winnipeg. Initial tests showed promise. Just one shot of the vaccine prevented macaque monkeys exposed to high levels of Ebola from getting sick.

But development of the drug faltered. Lengthy, expensive clinical trials didn’t happen, until the worst Ebola outbreak in recorded history unfolded more than a decade later, in 2014 and 2015. By then, the vaccine had been licensed to Merck, and its effectiveness in humans had been established.

More than 11,000 people died in the West Africa outbreak four years ago, and nearly 30,000 cases were recorded, mainly in Guinea, Liberia and Sierra Leone. Trials of V920 in the outbreak region helped reduce the caseload and ultimately stop the epidemic.

Ongoing funding

Keeping the virus contained and the death toll as low as possible will require ongoing funding, experts say.

“If funding is cut, it will really be pulling the rug out from under health security. And countries that look to other countries that can help will be left alone again as these things will continue,” said Cyrus Shahpar, the director of the Prevent Epidemics team at the Resolve to Save Lives initiative, a New York-based organization working to manage disease threats.

“The spread hasn’t gone away. Obviously we have this new Ebola outbreak, but I think that the memory of what happened in West Africa has kind of waned a bit, and so funding is also starting to wane. And I think it’s absolutely the wrong thing to do,” Shahpar said.
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Supervised by young engineers, workers at the start-up company Chakr Innovation in New Delhi cut and weld sheets of metal to make devices that will capture black plumes of smoke from diesel generators and convert it into ink. 

In a cabin, young engineers pore over drawings and hunch over computers as they explore more applications of the technology that they hope will aid progress in cleaning up the Indian capital’s toxic air – among the world’s dirtiest. 

While the millions of cars that ply Delhi’s streets are usually blamed for the city’s deadly air pollution, another big culprit is the massive diesel generators used by industries and buildings to light up homes and offices during outages when power from the grid switches off – a frequent occurrence in summer. Installed in backyards and basements, they stay away from the public eye. 

“Although vehicular emissions are the show stoppers, they are the ones which get the media attention, the silent polluters are the diesel generators,” says Arpit Dhupar, one of the three engineers who co-founded the start up. 

The idea that this polluting smoke needs attention struck Dhupar three years ago as he sipped a glass of sugarcane juice at a roadside vendor and saw a wall blackened with the fumes of a diesel generator he was using. 

It jolted him into joining with two others who co-founded the start-up to find a solution. Dhupar had experienced first hand the deadly impact of this pollution as he developed respiratory problems growing up in Delhi.

A new business

As the city’s dirty air becomes a serious health hazard for many citizens, it has turned into both a calling and a business opportunity for entrepreneurs looking at ways to improve air quality.

According to estimates, vehicles contribute 22 percent of the deadly PM 2.5 emissions in Delhi, while the share of diesel generators is about 15 percent. These emissions settle deep into the lungs, causing a host of respiratory problems. 

After over two years of research and development, Chakr has begun selling devices to tap the diesel exhaust. They have been installed in 50 places, include public sector and private companies.

The technology involves cooling the exhaust in a “heat exchanger” where the tiny soot particles come together. These are then funneled into another chamber that captures 70 to 90 percent of the particulate matter. The carbon is isolated and converted into ink. 

Among their first clients was one of the city’s top law firms, Jyoti Sagar Associates, which is housed in a building in Delhi’s business hub Gurgaon. 

Making a contribution to minimizing the carbon footprint is a subject that is close to Sagar’s heart – his 32-year-old daughter has long suffered from the harmful effects of Delhi’s toxic air.

“This appealed to us straightaway, the technology is very impactful but is beautifully simple,” says Sagar. Since it could be retrofitted, it did not disrupt the day-to-day activities at the buzzing office. “Let’s be responsible. Let’s at least not leave behind a larger footprint of carbon. And if we can afford to control it, why not, it’s good for all,” he says. 

At Chakr Innovation, cups, diaries and paper bags printed with the ink made from the exhaust serve as constant reminders of the amount of carbon emissions that would have escaped into the atmosphere. 

There has been a lot of focus on improving Delhi’s air by reducing vehicular pollution and making more stringent norms for manufacturers, but the same has not happened for diesel generators. Although there are efforts to penalize businesses that dirty the atmosphere, this often prompts them to find ways to get around the norms. 

Tushar Mathur who joined the start up after working for ten years in the corporate sector feels converting smoke into ink is a viable solution. “Here is a technology which is completely sustainable, a win-win between businesses and environment,” says Mathur. 
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