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Ebola: The Fight Continues Four Years After the Worst Outbreak in History

Macaya Douoguih volunteered to lead an accelerated clinical program for a new investigational Ebola vaccine at the height of the 2014 epidemic in West Africa. She reflects on her experiences—and why her work must continue today.
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Four years ago, the worst Ebola outbreak in history first emerged. In March 2014, the national health authorities of Guinea in West Africa notified the World Health Organization about a cluster of 49 Ebola cases in the country.

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Macaya Douoguih, Head of Clinical Development & Medical Affairs, Janssen Vaccines

By August that year, multiple countries in West Africa—including Guinea, Sierra Leone and Liberia—had reported outbreaks, and the World Health Organization declared a Public Health Emergency of International Concern.

The world was experiencing its first Ebola epidemic.

Yes, there had been numerous outbreaks of Ebola over the years—ever since the virus was first discovered in 1976. But nothing on this scale had ever happened.

Ten Clinical Trials, Three Continents, One Unprecedented Plan

In fact, the West African epidemic killed seven times more people than all of the 25 previous outbreaks combined. Nearly 29,000 people contracted Ebola in West Africa, and more than 11,000 people died of the disease.

I remember all of this very well—because I found myself at the heart of my employer’s response to the Ebola crisis.

In September 2014, upon witnessing the devastation in West Africa, we decided to accelerate the development of an investigational Ebola vaccine regimen at the Janssen Pharmaceutical Companies of Johnson & Johnson.

I volunteered to lead the accelerated clinical program for the new vaccine. And the prospect of doing this was truly daunting because, in the space of just one year, we launched 10 clinical trials across three continents. Janssen has never launched so many trials for an investigational drug or vaccine so quickly. It was unprecedented. And we could not have accomplished this without an overwhelming outflow of support within the organization, as well as the support of numerous global partners.

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The program was initiated in a primarily rural, Ebola-affected part of the country where no research or clinical studies had ever been conducted. There were few medical facilities and a lack of basic services, such as electricity and running water. We had to build a special depot to store our vaccine supplies for the study.

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One of the most challenging studies to launch was our ongoing study in Sierra Leone, “EBOVAC-Salone.”

It was initiated in a primarily rural, Ebola-affected part of the country called the Kambia District, where no research or clinical studies had ever been conducted previously. There were few medical facilities and a lack of basic services, such as electricity and running water. We had to build a special depot to store our vaccine supplies for the study. But the local community response was incredible, keeping our energy and momentum going.

Thankfully, the World Health Organization declared an end to the Ebola crisis in mid-2016. The West African epidemic had been brought to a halt by a diligent campaign of quarantine and contact tracing—traditional tactics used to contain a dangerous contagious disease.

Why Our Work Must Go On

So four years after the crisis began, where are we on an Ebola vaccine?

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A volunteer receives the first dose of the prime-boost vaccine regimen at a health clinic in Sierra Leone

Well, we’re not giving up! The end of the epidemic definitely made it challenging to conduct the kind of efficacy studies normally done for vaccines. But EBOVAC-Salone continues on, compiling important results regarding the immune response for Janssen’s investigational vaccine regimen.

And that’s not all. In March 2017, we reported one-year immunogenicity data from an early-stage UK study for the vaccine regimen in the Journal of the American Medical Association (JAMA), following initial clinical results reported in 2016.

Also, while recognizing this is an investigational vaccine still in development, we have taken pandemic preparedness steps with the goal of ensuring that the world is better equipped for Ebola outbreaks in the future. We filed for WHO Emergency Use Assessment and Listing status for the vaccine in 2016. And we’re committed to maintaining an inventory of 2 million Ebola vaccine regimens for potential use by health authorities in an emergency.

Looking to the future, you may be wondering how we will stop pandemic threats like Ebola. It’s a big question—a question we can’t ignore.

As a company, we believe that we can achieve this goal by working together to strengthen our healthcare systems. By training our front-line doctors, nurses and healthcare workers. By ensuring our governments are poised to take action. We are doing our part by developing medicines and vaccines, and convening partners.

Stopping the next epidemic will not be easy. But by bringing together the world’s public and private sectors, we can make a real difference in the world’s health.

Johnson & Johnson's Global Public Health team is at the forefront of combating infectious diseases worldwide—like Ebola and HIV.

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