Safeguarding against Ebola: Vaccines and therapeutics to be stockpiled for future outbreaks

The Ebola virus outbreak of 2014 to 2016 had severe and devastating consequences for the people of West Africa, with more than 28,000 cases and 11,000 deaths across Liberia, Sierra Leone, and Guinea [1]. This epidemic exposed inadequacies in the medical countermeasure preparedness of international governments and organizations that limited their ability to effectively address the spread of the Ebola virus. Although Ebola virus had been circulating in Africa for decades with periodic outbreaks [1], funding for filoviruses has been limited to preclinical evaluation and establishment of assays and reagents that were necessary to quickly evaluate vaccine and therapeutic candidates. The few medical countermeasures that existed were stalled in early stages of development, a consequence of several factors, including insufficient funding to advance candidates, an uncertain regulatory path for development, and constraints associated with Biosafety Level 4 containment suites for research using Ebola viruses As the West Africa Ebola epidemic grew in scale, governments, international organizations, nongovernment organizations, and industry scrambled to mount an effective response to contain the outbreak The United States government (USG) and others invested millions of dollars to accelerate the development of vaccine, therapeutic, and diagnostic candidates from early preclinical development into manufacturing scale-up and clinical trials Several of these clinical trials were conducted in West Africa, which offered the potential to have a direct impact on the ongoing outbreak and demonstrate clinical efficacy of the medical countermeasures. Ultimately, the early development of these medical countermeasures was led by collaborative efforts across multiple organizations and countries. For example, early development of both vaccines and therapeutics can be attributed to organizations such as the National Institutes of Allergy and Infectious Diseases (NIAID), the US Army Medical