How Will We Ensure the New Ebola Vaccine Reaches Those Most in Need?

How will this new tool be used? How will it reach those in need? Rapid availability of the vaccine is key and as with all health technologies, access to and delivery of the drug will depend on the capacity of the very health systems that have been decimated by Ebola.
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A health worker, left, injects a man in his arm with an Ebola vaccine in Conakry, Guinea, March 7, 2015. The World Health Organization will start large-scale testing of an experimental Ebola vaccine in Guinea on Saturday to see how effective it might be in preventing future outbreaks of the deadly virus. The West African nations of Sierra Leone, Liberia and Guinea have been hardest hit in the yearlong Ebola outbreak, which is estimated to have left more than 9,800 people dead. (AP Photo/ Youssouf Bah)
A health worker, left, injects a man in his arm with an Ebola vaccine in Conakry, Guinea, March 7, 2015. The World Health Organization will start large-scale testing of an experimental Ebola vaccine in Guinea on Saturday to see how effective it might be in preventing future outbreaks of the deadly virus. The West African nations of Sierra Leone, Liberia and Guinea have been hardest hit in the yearlong Ebola outbreak, which is estimated to have left more than 9,800 people dead. (AP Photo/ Youssouf Bah)

We have reasons to be optimistic about the news of a new tool in the fight against Ebola. As in the fight against HIV, science and solidarity have come together to save lives. The phase III trials on efficacy of the VSV-ZEBOV vaccine have yielded an impressive result in a relatively short time -- 100 percent effectiveness in those receiving the vaccine.

While scientists still need to figure out how long the protective effect of the vaccine lasts, and how effective it will be among the general population and with different strains of the virus, without a doubt this is an important tool for the protection of health and community workers and possibly the wider community. This will certainly help in the on-going efforts to achieve the target of zero new Ebola cases and in overall recovery efforts.

But how will this new tool be used? How will it reach those in need? Rapid availability of the vaccine is key and as with all health technologies, access to and delivery of the drug will depend on the capacity of the very health systems that have been decimated by Ebola. Researchers tell us that this particular vaccine has to be kept at -80 degrees Celsius. How will this be done in tropical climates, where basic health infrastructure is incredibly weak? Without reliable power supplies, it will be difficult to ensure the optimal conditions for storing the vaccine.

Science can provide much needed solutions. But without the right systems in place, the solutions will not reach those in need. Unfortunately health systems in many places are chronically weak. The response to HIV has shown us that investments in building national and local capacities and systems for health that reach beyond Ministries of Health can yield incredible dividends for individuals and communities.

The United Nations Development Programme (UNDP)'s experience supporting countries to effectively deliver Global Fund financed HIV, TB and malaria programmes has shown that comprehensive capacity development across the prevention -- treatment continuum is essential and possible, even in the most complex and challenging of environments. This outbreak of Ebola has shown us that resilient health systems are those that are risk-informed and can be equipped to withstand shocks and mitigate their effects.

One of the unintended consequences of the Ebola outbreak was a negative spillover effect on other health issues -- adding to the complexity and severity of the crisis.

For example, in all three Ebola-affected countries, basic essential health care services have been and continue to be severely disrupted. According to UNFPA, an estimated 800,000 women will give birth in 2015 in the three countries, but some 120,000 of them may die from lack of access to emergency obstetrics care, while health services have been diverted towards Ebola.

In Sierra Leone, only one-fifth of the 10,000 HIV patients on life-saving HIV treatment are still receiving them due to the current lack of health personnel available for non-Ebola care. Other related consequence included the loss of jobs and opportunities and threats to food security. In Sierra Leone, during the Ebola outbreak 50% of private sector jobs were lost and in Liberia, household income dropped by 35.13% in just six months.

As important as the bricks, mortar, health technologies and trained health workforce are, the meaningful engagement and trust of communities is as important, if not more so. The initial response to the Ebola outbreak eroded hard-won trust among communities, perpetuated stigma and discrimination against Ebola patients, survivors and their families, and diminished people's confidence in health services and the government more broadly.

Local community responses were critical in turning the tide of Ebola and community engagement is what will get us to zero new cases of Ebola. As with HIV, Ebola survivors and community volunteers have played an important role in reducing stigma by assisting in the identification of cases, contact tracing and awareness raising and educating people on how the disease is spread and how to avoid contracting it.

Community preparedness is also a key component of vaccination programmes and will be crucial for the successful introduction of the VSV-ZEBOV vaccine. Research has shown that community participation in immunization programmes results in higher coverage and reduces the incidence of vaccine-preventable diseases. Investing in community engagement will be crucial for the success of the vaccine and hopefully preventing future outbreaks of this magnitude.

Close to five billion dollars have been pledged for Ebola recovery in the three affected countries. If we want to reap the benefit of new tools such as this vaccine and get beyond zero cases of Ebola, we need to invest urgently in building resilient health systems and communities. This means addressing the immediate health, economic and security needs of affected communities. Without development, science cannot benefit those most in need.

For more information on UNDP's efforts to contain the disease and help countries to recover from the crisis it has caused, visit www.undp.org/ebola.

Originally published on Le Huffington Post.

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