WHO: Ebola Virus Disease (EVD)
Situation report – 5 November 2014 ‘WHO Roadmap’
HIGHLIGHTS
:: There have been 13,042 reported cases of Ebola, with 4818 reported deaths, up to the end of 2 November.
:: All districts in Liberia and Sierra Leone have been affected.
:: All 83 contacts of the health-care worker infected in Spain have completed 21-day follow-up
[Excerpt from Summary]
…At the country level, the weekly incidence appears to be stable in Guinea. In Sierra Leone the weekly incidence continues to rise, while in Liberia it appears to be declining. In all three countries, EVD transmission remains persistent and widespread, particularly in the capital cities. All administrative districts in Liberia and Sierra Leone have reported at least 1 confirmed or probable case of EVD since the outbreak began. Cases and deaths continue to be under-reported in this outbreak.
Of the countries with localized transmission, Mali and the United States of America continue to monitor potential contacts. In Spain, all 83 contacts of the health-care worker infected in Madrid have completed the 21-day follow-up period.

WHO welcomes approval of a second Ebola vaccine trial in Switzerland
Statement
6 November 2014
WHO welcomes approval by Swissmedic, the Swiss regulatory authority for therapeutic products, of a second Swiss trial of an experimental Ebola vaccine. The trial will be led by the University Hospitals of Geneva (HUG). If judged safe, larger scale trials will be taken to African countries as early as January 2015.
This trial approval means that the vaccine will be tested on approximately 115 volunteers in Geneva. The trial, which is receiving support from WHO, is the latest in a series of trials involving 2 different candidate Ebola vaccines that are ongoing in Switzerland, Mali, the United Kingdom, and the United States.
About the vaccine
The experimental VSV-ZEBOV vaccine has been developed by scientists at the Public Health Agency of Canada . It is based on the virus that causes vesicular stomatitis, a disease affecting animals. This virus has been weakened and genetically modified to express the glycoprotein of the Zaire Ebola virus (ZEBOV) so as to provoke an immune response against real Ebola viruses.
The experimental vaccine will be tested on healthy volunteers, some of whom will be deployed as health care staff in the fight against the Ebola epidemic in West Africa. The trial will test the safety of the vaccine and its ability to provoke an immune response. VSV-ZEBOV is also being tested on healthy volunteers in the USA (the first trial started 13 October) and trials are planned to start very soon in Germany, Gabon and Kenya.
Vaccine trials
The trial is the second one organised in Switzerland and coordinated by WHO. The first vaccine, “ChAd3″ – Chimpanzee-Adenovirus ChAd3-ZEBOV – started trials in Lausanne at the end of October….

WHO: African regulators’ meeting looking to expedite approval of vaccines and therapies for Ebola
November 2014
Aiming to make potential Ebola therapies and vaccines available as quickly as possible, the ninth African Vaccine Regulatory Forum (AVAREF), taking place in Pretoria, South Africa, from 3-7 November, will devote the first two days to agree on a collaborative mechanism for fast tracking approvals for clinical trials and registration of these products in the affected countries.
“As the President of Liberia has aptly put, the best cure for Ebola is stronger health systems,”
said Kees De Joncheere, WHO Director for Essential Medicines and Health products.
“It is crucial that we match the speed with which Ebola vaccines are being developed and tested with equal haste in making them available to populations once they are judged safe and effective,” said Sarah Barber, WHO Representative in South Africa. “To do that, we need to agree on the design of clinical trials, and we need to collaborate across borders to fast-track scientific assessment, regulatory approval and roll-out.”
The mechanism would cover:
:: Clear pathways and timelines for expedited ethical and regulatory review of clinical trial applications and approval of products;
:: Agreement on timelines and joint safety and efficacy assessments of the new products to fast-track national registration;
:: Endorsement of a panel of safety experts for expedited review of safety data of new products with relevant communication to National Regulatory Authorities (NRAs);
:: Technical assistance from the World Health Organization (WHO) to facilitate these processes.
Ebola, which has killed close to 5 000 people so far and crushed the already weakened health systems of Guinea, Liberia and Sierra Leone, had until recently received little attention from the pharmaceutical sector. The current outbreak, unprecedented in geographical scope and severity, has mobilised numerous private and public stakeholders to accelerate the development of vaccines to contain the outbreak and prevent other such crises in the future.
Three vaccines are currently undergoing human safety trials outside Africa. Once they are judged safe, further trials will take place in the countries affected by Ebola. The vaccines are being developed respectively by Glaxo-Smith-Kline with the US Government, Johnson & Johnson, and the Canadian Public Health Agency.
At the same time, partnerships between WHO and some member states are looking to the plasma of Ebola survivors, who have built antibodies to the virus, as a possible therapeutic option for people who are already infected. The plasma clinical trials will also need expedited review by ethics committees and regulators. If judged safe and effective, this therapy can be rolled out rapidly.
The Pretoria meeting will bring together public health officials, regulatory and industry experts from 25 African countries and international health stakeholders. The meeting has awakened broad interest among African governments because the accelerated mechanism fast track process it will put in place could be used as a model for other countries to accelerate access to potentially useful therapies in emergency situations.
“As the President of Liberia has aptly put, the best cure for Ebola is stronger health systems,” said Kees De Joncheere, WHO Director for Essential Medicines and Health products. “That wake-up call could turn things around for Africa and represent another step towards increasing access to and better regulation of health products,
AVAREF
AVAREF was founded in 2006 by WHO to support NRAs in making informed decisions concerning authorization of clinical trials, evaluation of product registration dossiers, and any other challenging issues related to vaccines evaluation. AVAREF provides African regulatory authorities charged with ensuring the safety of medical products and related research with expertise and opportunities for information sharing and capacity building. It also offers product developers the opportunity for joint review by regulatory authorities from multiple countries of clinical trial and marketing authorization applications for high priority vaccines to be used in African countries. While initially focused on vaccines, AVAREF is beginning to expand to cover medicines and diagnostics as well.

WHO Guidance: How to conduct safe and dignified burial of a patient who has died from suspected or confirmed Ebola virus disease
October 2014 :: 17 pages
WHO/EVD/Guidance/Burials/14.2
Download the full version in English
Overview
This protocol provides information on the safe management of dead bodies and burial of patients who died from suspected or confirmed Ebola virus disease.
These measures should be applied not only by medical personnel but by anyone involved in the management of dead bodies and burial of suspected or confirmed Ebola patients.
Twelve steps have been identified describing the different phases Burial Teams have to follow to ensure safe burials, starting from the moment the teams arrive in the village up to their
:: Read the note for media

WHO: Ebola situation assessments
:: New study sheds light on the importance of supportive care for Ebola patients 6 November 2014

WHO IN ACTION
:: Government of Senegal boosts Ebola awareness through SMS campaign
3 November 2014

Related News on Ebola
:: Statement from the Travel and Transport Task Force on Ebola virus disease outbreak in West Africa 7 November 2014
WHO does not recommend general bans on travel or trade
Leading international organizations and associations from the transport, trade and tourism sector stand firmly with WHO against general bans on travel and trade, as well as restrictions that include general quarantine of travellers from Ebola-affected countries.
The Travel and Transport Task Force, established in August 2014, calls for international cooperation of governments and the transport sector in following the recommendations of the International Health Regulations Emergency Committee on Ebola, convened by WHO.
WHO does not recommend general bans on travel or trade, or general quarantine of travellers arriving from Ebola-affected countries, as measures to contain the outbreak.
Such measures can create a false impression of control and may have a detrimental impact on the number of health care workers volunteering to assist Ebola control or prevention efforts in the affected countries. Such measures may also adversely reduce essential trade, including supplies of food, fuel and medical equipment to the affected countries, contributing to their humanitarian and economic hardship….
…About the Travel and Transport Task Force
Members of the Travel and Transport Task Force include the World Health Organization (WHO), the International Civil Aviation Organization (ICAO), the World Tourism Organization (UNWTO), Airports Council International (ACI), International Air Transport Association (IATA), World Travel and Tourism Council (WTTC) International Maritime Organization (IMO), the International Chamber of Shipping (ICS) and the Cruise Lines International Association (CLIA).
:: WHO welcomes strong commitment from Australia to beating Ebola
6 November 2014