Our Perspectives

How will we ensure the new Ebola vaccine reaches those most in need?


A family recovering from the impact of Ebola in Liberia.Community participation in immunization programmes results in higher coverage and reduces the incidence of vaccine-preventable diseases. Photo: UNDP Liberia

We are optimistic about a new tool in the fight against Ebola. The phase III trials on efficacy of the VSV-ZEBOV vaccine have yielded an impressive result in a relatively short time - 100% effectiveness in those receiving the vaccine.

Scientists still need to figure out how long its protection lasts, and how effective it will be among the general population and with different strains of the virus.  But 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.

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. This particular vaccine has to be kept at -80 degrees Celsius. How will this be done in tropical climates, where basic health infrastructure is often 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, these solutions will not reach those in need.  The HIV response 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.

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 and 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 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, which added to the complexity and severity of the crisis. In all three Ebola-affected countries, basic essential health care services have been and continue to be severely disrupted.

As crucial as health services, technologies, and trained health workforce are, the trust and meaningful engagement of communities is just as important. 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.

Local community responses were critical in turning the tide of Ebola. As with HIV, Ebola survivors and community volunteers have played an important role in reducing stigma, assisting in the identification of cases, 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.

Close to US$5 billion has 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 recover from the crisis, visit www.undp.org/ebola.

The full version of this blog post was originally published in the Huffington Post.

Africa Liberia Guinea Sierra Leone Crisis response Health Mandeep Dhaliwal

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