In Bunia, the first volunteers have received shots in a trial called Tumaini—the Swahili word for “hope”—as health workers search for a way to stop the Democratic Republic of Congo’s worst-ever Ebola outbreak. The trial began Friday in Ituri province, the outbreak’s epicenter, with the existing vaccine Ervebo.
The outbreak has passed 9,700 cases and 4,600 deaths. It is caused by the Bundibugyo species of Ebola, for which no vaccine or treatment has been approved. Ervebo is approved against the more common Zaire strain, so researchers will test whether it also offers protection against Bundibugyo. The goal is to find out what works, using evidence gathered during the response.
World Health Organization chief Tedros Adhanom Ghebreyesus announced the first vaccinations in Bunia. He said the WHO is supporting a trial led by the Democratic Republic of Congo. WHO emergencies director Chikwe Ihekweazu said the study is designed to produce strong evidence on whether the vaccines can protect people at risk. If the trial shows that a vaccine works against Bundibugyo, it would provide the first clear evidence of vaccine protection against the virus, he said.
Tumaini is set up as one trial that can assess several vaccines for safety, how well they work, and how the body responds to them. It will use “ring vaccination”: people judged to be at high risk because of contact with an Ebola case will be offered shots. The trial is also expected to include pregnant women and children aged 12 and older, groups often left out of clinical studies.
Ervebo is the first vaccine being tested in the study. Two vaccines designed specifically for Bundibugyo are also moving through smaller, earlier-stage trials and are expected to join Tumaini shortly, according to the Coalition for Epidemic Preparedness Innovations, which has funded both. One is an adenovirus-based vaccine being developed by the University of Oxford. The other, from US company Moderna, uses mRNA technology. Their addition would let researchers compare candidates within the same trial framework.
The work comes as the DRC faces its 17th Ebola outbreak, declared on May 15. Two days later, the WHO declared a public health emergency of international concern, its second-highest alert level. Ebola spreads through contact with bodily fluids and causes a severe fever that can lead to bleeding. It has killed more than 15,000 people in Africa over the past 50 years.
For people in affected communities, the trial is a practical effort to answer an urgent question while the outbreak continues. DRC response incident manager Steve Ahuka-Mundeke called bringing the study into the response an important step. Researchers will work with communities, health authorities and response partners, and the findings could help guide this outbreak response as well as preparation for future Bundibugyo outbreaks. As Tedros put it: “Science gives us hope.”