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Ebola expert: We were very lucky

Published 04/06/2015

Ebola expert Professor Adrian Hill said there had been the potential for
Ebola expert Professor Adrian Hill said there had been the potential for "things to really get out of control"

The British Government's response to the Ebola epidemic in West Africa last year was "too late", according to a leading expert on the disease.

Professor David Evans said it took six months from when the outbreak was first reported last year for an international response to be launched.

The epidemic, which is spread by migrating bats, swept West Africa and rapidly become the deadliest since the virus was discovered in 1976 - killing five times more than all other known Ebola outbreaks combined.

In August, the World Health Organisation (WHO) declared an "international public health emergency" and called for a co-ordinated response to halt the spread.

During an event with a panel of experts at the Cheltenham Science Festival discussing last year's disaster, Prof Evans was asked about the British Government's response.

"I think probably too late, actually," the Warwick University virologist said.

"The media interest and the pressure started in August.

"After that, things geared up very quickly and they got the logistics in place.

"The outbreak was being discussed in scientific circles in February and March.

"Medecins Sans Frontieres were making quite a lot of noise about it early on.

"And not just the British Government but other governments stepped in rather late."

Another member of the panel, Professor Adrian Hill, said: "The potential was there for things to really get out of control.

"This response had to be done.

"We just don't know what would have happened otherwise.

"In retrospect we were very lucky - we were just in time."

Since March last year, more than 11,000 people have been reported as having died from Ebola in six countries - Liberia, Guinea, Sierra Leone, Nigeria, the US and Mali.

The total number of reported cases is more than 27,000.

The WHO has declared the outbreaks in Nigeria and Senegal officially over as there have been no new cases reported since September.

The outbreak in Liberia, which has had the highest number of deaths out of all the countries affected, was declared over last month.

Ebola, which was first identified in 1976, occurs in regions of sub-Saharan Africa.

There are normally fewer than 500 cases reported each year, and no cases were reported at all between 1979 and 1994.

Prof Hill, who last year led the first clinical trial of a monovalent Ebola vaccine, also criticised the need to develop a vaccine during an outbreak, saying that stockpiles should already have been available.

"Frankly we shouldn't have been doing this," he said.

"We shouldn't have been put in a position where we were trying to do something that has never been done before - bring a vaccine into clinical testing and deploy it - during an outbreak.

"In other words, we should be prepared rather than doing an exceptional rapid response.

"Focusing on the vaccine side, the UK punched above its weight.

"Of the five Ebola candidate vaccines that were tested last year, four of them were tested first in the UK.

"Two of them were supposed to be tested in Belgium but they couldn't get it through the Belgium system fast enough.

"The UK has a very efficient regulatory framework for assessing new types of vaccine and we took advantage of that.

"I think the UK played a very important role in Sierra Leone.

"A lot of UK money went into this response and there was a lot of influence at the World Health Organisation by UK people."

Prof Hill, who works at Oxford University, warned that Ebola was the tip of the iceberg as there were more than a dozen other deadly viruses with no known vaccine.

"This is a bigger issue than just for Ebola vaccines because there are 15 viruses that cause outbreaks in humans, such as Sars, Pandemic flu, Lassa fever and West Nile virus, we don't have a vaccine against any of them," he said.

"Why you may ask, given the billions of dollars we have had to spend controlling the outbreak in West Africa?

"Very simply there is a market failure.

"If you are a big vaccine company, and any of these if we are lucky might never come back, you are not going to invest hundreds of millions of pounds in making a vaccine which might never be needed.

"If you think about that, we need a different solution - not just criticising the vaccine industry.

"We need probably a public-private partnership with government money, foundation money and industrial money going in to make these vaccines.

"I would say we need them pretty soon because we have already seen multiple Ebola outbreaks in recent years, Mers is spreading and we don't know what is going to come next.

"This is an urgent problem.

"I don't think we need to spend hundreds of millions of pounds on each of these.

"We need to make small stockpiles, check they are safe, check they make the right immune response and have them ready to use."

Prof Evans warned that in the future humans could be infected by other unknown viruses caught from animals and the Western world needed to be prepared.

"This particular outbreak probably won't be the last of Ebola," he said.

"There are undoubtedly things out there that we have no knowledge about at the moment and will be exposed to in the future and we need some level of preparedness.

"Perhaps having a team of people, and perhaps having the expertise both in terms of the crisis management and in terms of the types of drugs and the types of interventions used and potential vaccine strategies, would provide a kind of first line of response which would benefit the individuals and countries effected."

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