The vaccine will be tested in a study, the first in seven years to test a vaccine against HIV, the National Institutes of Health, which is funding the study, said on Monday.

A statement says the vaccine, known as HVTN 702, will undergo the largest and most advanced clinical trial in South Africa, where more than 1,000 people are infected with HIV daily.

“If deployed alongside our current armoury of proven HIV prevention tools, a safe and effective vaccine could be the final nail in the coffin for HIV,” Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, said in a statement on Sunday.

The vaccine is a modified version of the only one to have shown a positive effect of many that have gone on trials so far.

Seven years ago, a vaccine known as RV144 that was tested in Thailand was found to be about 31 per cent effective after 3.5 years of follow-up.

That trial was, however, controversial as the vaccine was a combination of two where one, called AidsVax, was ineffective on its own.

But researchers in constant search for a vaccine, think they could have better success in South Africa because of a number of modifications.

Already, 5,400 sexually active men and women aged 18 to 35 who do not have HIV have been enrolled for the trials and results are expected in 2020.

The volunteers will get five shots of the vaccine and three boosters — a schedule the researchers will cut down for use in the real world if it is successful. The results will set a precedence for Kenya’s yet to be launched vaccine trials expected in February.

Director of University of Nairobi’s Kenya Aids Vaccine Initiative-Institute of Clinical Research Prof Omu Anzala said if the South African vaccine shows promise, we will learn something from it to improve what we will come up with in future,” he said.

“We have tried at least 14 vaccines and will test a new one next year,” he said.

At least two-thirds of the participants will be women, who are more likely to get infected at the age 18-35 than men.

“The toolbox is in desperate need of something like this. We remain very optimistic,” said Prof Linda-Gail Bekker, of the University of Cape Town and president of the International AIDS Society. </s> In line with World Aids Day tomorrow, Thursday 1 December, a landmark clinical trial to test whether a vaccine regimen can prevent HIV infection in the South African population, kicks off today.

5 400 participants, 15 sites

 The vaccine will be administered to 5 400 participants in the trial at 15 research sites. It will take about 20 months for the vaccine to be administered to all the participants in the trial.



 1st sites activated

 They are the MRC HRPU Research Site in Verulam and the Setshaba Research Centre in Soshanguve. Activation of the Emavundleni Clinical Research Centre is expected to take place soon.



 1000 people per day

 With more than 1 000 people becoming infected with HIV every day in South Africa we are in dire need of better HIV prevention options despite recent advances. A safe and effective HIV vaccine would go a long way towards ending HIV in the country.



 HVTN 702 trial
• is the only efficacy trial of a preventive HIV vaccine taking place anywhere in the world at present
• is the first such trial to be launched in seven years and that solely in South Africa
• is the largest and most advanced HIV vaccine trial yet launched in southern Africa

 The vaccine

 A modified form of the only vaccine regimen that has shown a measure of efficacy in preventing HIV infection will be used in the trial. The regimen was tested in the RV144 trial which is known as the Thai study. A 31 percent reduction in HIV infections after 3.5 years was reported.

 

 The modified vaccine has been tested in a smaller trial HVTN 100 with the immune-system response shown by participants meeting the expected criteria thus justifying proceeding with HVTN 702. A modified form of the only vaccine regimen that has shown a measure of efficacy in preventing HIV infection will be used in the trial. The regimen was tested in the RV144 trial which is known as the Thai study. A 31 percent reduction in HIV infections after 3.5 years was reported.The modified vaccine has been tested in a smaller trial HVTN 100 with the immune-system response shown by participants meeting the expected criteria thus justifying proceeding with HVTN 702.



 The trial

 It will test whether a combination of vaccines is:
• Safe for use and well-tolerated by those receiving it
• Effective in preventing HIV among people who have not been infected with HIV

 All volunteers must be aged between 18 and 35, sexually active, in general good health and HIV-negative.

 

 HVTN 702 is a placebo-controlled trial, meaning that participants are randomly assigned to two groups where one group will receive the test vaccines and the other will receive a placebo which is a simple saline solution.

 

 During the trial all participants will be counselled to continue using established methods of HIV protection, but existing methods are imperfect and some participants will acquire HIV during the study. It will test whether a combination of vaccines is:All volunteers must be aged between 18 and 35, sexually active, in general good health and HIV-negative.HVTN 702 is a placebo-controlled trial, meaning that participants are randomly assigned to two groups where one group will receive the test vaccines and the other will receive a placebo which is a simple saline solution.During the trial all participants will be counselled to continue using established methods of HIV protection, but existing methods are imperfect and some participants will acquire HIV during the study.

The result

 If HVTN 702 shows the study vaccine to be effective, this trial could dramatically change the course of the HIV epidemic.

23-year old Nkosiyaze Ncube from Inanda is the first person to be injected with the new HIV vaccine.

NATIONAL NEWS & VIDEO - The HVTN 702 vaccine trial in SA is currently the only HIV trial being conducted in the world. </s> South Africa on Wednesday began a major clinical trial of an experimental vaccine against the AIDS virus, which scientists hope could be the “final nail in the coffin” for the disease.

More than 30 years of efforts to develop an effective vaccine for HIV have not borne fruit, but for the first time since the virus was identified in 1983, scientists think they have found a promising candidate.

The new study, known as HVTN 702, will involve more than 5,400 sexually active men and women ages 18 to 35 in 15 areas around South Africa over the course of four years.

It is one of the biggest clinical trials involving the disease ever undertaken and has revived hopes in the scientific community of a breakthrough in the battle against AIDS.

“If deployed alongside our current armory of proven HIV prevention tools, a safe and effective vaccine could be the final nail in the coffin for HIV,” said Anthony Fauci, director of the U.S. National institute for Allergies and Infectious Diseases (NIAID), which is taking part in the study.

“Even a moderately effective vaccine would significantly decrease the burden of HIV disease over time in countries and populations with high rates of HIV infection, such as South Africa.”

Condoms are at the front line of efforts to prevent the spread of HIV, which is mainly transferred through the sexual fluids and blood of infected individuals.

A small number of people, mainly in developed countries, use virus-suppressing drugs as a preventive aid, although the exact level of protection this offers is not clear.

South Africa was not chosen by accident. The country has one of the highest rates of HIV infection in the world — 19.2 percent, according to the U.N. AIDS agency — with more than 7 million people living with the virus.

Each year some 2.5 million people around the world are infected with HIV, which has killed more than 30 million people since the 1980s, according to a study presented at a conference in South Africa in July.

The vaccine has been adapted for the HIV strain prevalent in southern Africa from one used in a trial of 16,000 people in Thailand in 2009, which reduced the risk of infection by more than 30 percent for 3½ years after the first shot.

The safety of the “South African” vaccine has already been tested successfully over 18 months on 252 volunteers. The new study aims to test its effectiveness as a virus-killer.

Vaccines work by priming the body to respond with germ-fighting antibodies whenever a virus or bacteria invades. But the AIDS-causing virus is stealthy and quick to mutate to avoid being targeted.

“The results obtained in Thailand are not good enough for a roll-out. … We have set the minimum bar at 50 percent” lower risk, Lynn Morris, head of the HIV virology section at South Africa’s National Institute for Communicable Disease (NICD), said.

South Africa’s Deputy President Cyril Ramaphosa told parliament in November that “scientists expect the (new) vaccine to be at least 50 percent effective but hope that it will be much higher.”

Even if the new vaccine proves effective, experts warn it is vital to remain vigilant in the fight against HIV.

“A highly efficient vaccine would be a game-changer, but the results of these trials will take years,” Morris said.

“We must continue to use other HIV prevention tools to reduce the number of new HIV infections, particularly in vulnerable populations such as young women, who continue to be most heavily affected.”

According to UNAIDS, half of the 36 million or so people with HIV around the world have access to anti-retroviral drugs (ARVs), a figure that has doubled in five years.

Thanks to these treatments, which keep the virus in check and increase the life span of HIV-positive people without curing them, average life expectancy in South Africa has risen from 57.1 years to 62.9 since 2009, according to authorities.

The new trial is being carried out by the U.S. National Institutes of Health, the South African Medical Research Council, the Bill and Melinda Gates Foundation, Sanofi Pasteur, GlaxoSmithKline and the HIV Vaccine Trials Network. </s> South Africa has launched a major clinical trial of an experimental vaccine against the AIDS virus, which scientists hope could be the "final nail in the coffin" for the disease.

More than 30 years of efforts to develop an effective vaccine for HIV have not borne fruit, but for the first time since the virus was identified in 1983, scientists said on Wednesday they think they have found a promising candidate.

The new study, known as HVTN 702, will involve more than 5,400 sexually active men and women aged 18-35 in 15 areas around South Africa over four years.

Homeless HIV patient removed for Durban AIDS summit

It is one of the biggest clinical trials involving the disease ever undertaken and has revived hopes of a breakthrough in the battle against AIDS.

"If deployed alongside our current armoury of proven HIV prevention tools, a safe and effective vaccine could be the final nail in the coffin for HIV," said Anthony Fauci, director of the US National institute for Allergies and Infectious Diseases (NIAID), which is taking part in the study.

"Even a moderately effective vaccine would significantly decrease the burden of HIV disease over time in countries and populations with high rates of HIV infection, such as South Africa."

Condoms are at the frontline of efforts to prevent the spread of HIV, which is mainly transferred through the sexual fluids and blood of infected individuals.

A small number of people, mainly in developed countries, use virus-suppressing drugs as a preventive aid, although the exact level of protection this offers is not clear.

But relying on existing prevention methods was not working, said Mmapule Raborife, one of HIV Vaccine Trials Network's community advisors in the large township of Soshanguve, north of the administrative capital Pretoria.

'Condoms everywhere'

"There are condoms everywhere in South Africa but people are just passing by as if there is nothing there," she told AFP news agency.

South Africa was not chosen by accident. The country has one of the highest rates of HIV infection in the world - 19.2 percent according to the UN AIDS agency - with more than seven million people living with the virus.

"A vaccine is critical for South Africa," said Glenda Gray, president of the country's Medical Research Council.

"Every day, 1,000 people are getting infected and most of them are young women and men so we need to find a solution."

The vaccine has been adapted for the HIV strain prevalent in southern Africa from one used in a trial of 16,000 people in Thailand in 2009, which reduced the risk of infection by more than 30 percent for three-and-a-half years after the first jab.

The safety of the vaccine has already been tested successfully over 18 months on 252 volunteers. The new study aims to test its effectiveness as a virus-killer.

Vaccines work by priming the body to respond with germ-fighting antibodies whenever a virus or bacteria invades. But the AIDS-causing virus is stealthy and quick to mutate to avoid being targeted.

"If we have a 50 percent efficacy rate, we would consider this an effective vaccine," said Gray.

From there, it could take five to 10 years to scale up production, "and we need money to take [it] to a world level", she added.

Even if the new vaccine proves effective, experts warn it is vital to remain vigilant in the fight against HIV.

"A highly efficient vaccine would be a game-changer but the results of these trials will take years," Lynn Morris, head of the HIV virology section at South Africa's National Institute for Communicable Diseases (NICD), told AFP.

"We must continue to use other HIV prevention tools to reduce the number of new HIV infections, particularly in vulnerable populations such as young women."

How Malawi reduced its HIV/Aids infection rate

According to UNAIDS, half of the 36 million or so people with HIV around the world have access to anti-retroviral drugs (ARVs), a figure that has doubled in five years.

Thanks to these treatments, which keep the virus in check and increase the lifespan of HIV-positive people without curing them, average life expectancy in South Africa has risen from 57.1 years to 62.9 since 2009.

"I know people who are HIV positive and I know people who died because of HIV - some of them are in my family," one trial participant who declined to give her name.

"I want to make a difference in my community and in my country... There's no cure yet, so we have to keep fighting." </s> The stakes are high. It’s the first study of its kind begun in seven years, and even moderate success could prove important not only in hard-hit South Africa, where more than 1,000 people a day are infected with HIV, but beyond.

“If an HIV vaccine were found to work in South Africa, it could dramatically alter the course of the pandemic,” Glenda Gray, president of the South African Medical Research Council, said Wednesday at one of the test clinics in Soshanguve township outside Pretoria. The council is helping run the study.

Developing a vaccine against the virus that causes AIDS is one of science’s greatest challenges, and the field is littered with failures. Better medications have greatly improved survival for many people, turning the virus into a chronic disease rather than a quick killer. But there is no cure, and there still are a million AIDS-related deaths a year.

The new study is based on the only vaccine attempt ever to show even marginal effectiveness, in Thailand in 2009 — a two-vaccine combination that cut the risk of HIV infection by 31 percent over 3½ years. That wasn’t nearly effective enough to use outside of research, but scientists immediately started trying to modify and improve that combination.

A small safety test in South Africa earlier this year showed that the modified vaccine combo was promising enough for a major study to probe if it really works.

The new vaccine aims to provide “greater and more sustained protection,” Mookho Malahleha, a researcher involved in the project who was at the Soshanguve clinic.

The new study, funded in part by the U.S. government’s National Institute of Allergy and Infectious Diseases, will enroll 5,400 sexually active men and women between 18 and 35 at sites across South Africa. Volunteers for the study will be randomly assigned to receive either five vaccine injections over a year or five placebo shots.

Results are expected in 2020. Participants who become infected with HIV will be referred to local medical providers for care and treatment and will be counseled on how to reduce their risk of transmitting the virus.

People cannot be infected through the vaccine.

The vaccine combination consists of two experimental shots — ALVAC-HIV supplied by drug maker Sanofi Pasteur, and a protein vaccine supplied by GlaxoSmithKline — that form what’s called a “prime-boost” approach. One shot primes the immune system to attack HIV and another strengthens that response. For the South African trial, the shots were adapted to the most common HIV strain in southern Africa, and scientists added an additional booster dose in hopes of prolonging protection.

South Africa has more than 6.8 million people living with HIV, but the country has had success in rolling out an HIV drug treatment program for 3.1 million people, the largest in the world, according to Doctors Without Borders. Life expectancy in South Africa, which sank as the epidemic grew, has rebounded from 57.1 years in 2009 to 62.9 years in 2014. </s> A new HIV vaccine is now being tested in South Africa in a study that aims to enroll several thousand people, officials announced today.

The study is the first in seven years to test the effectiveness of a vaccine against HIV, said the National Institutes of Health (NIH), which is funding the study.

"If deployed alongside our current armory of proven HIV-prevention tools, a safe and effective vaccine could be the final nail in the coffin for HIV," Dr. Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, said in a statement. "Even a moderately effective vaccine would significantly decrease the burden of HIV disease over time in countries and populations with high rates of HIV infection."

In South Africa, more than 1,000 people contract HIV each day, the NIH said.

The last HIV vaccine to show promise was tested in Thailand starting in 2003. In 2009, researchers from that study announced that the vaccine was 31 percent effective at preventing HIV infection over 3.5 years.In other words, the rate of infection was 31 percent lower in the group that got the vaccine, compared to the group that got a placebo.

The new South African study will use an HIV vaccine that is similar to the one used in the Thai study but that has been modified to provide greater and longer-lasting protection, the researchers said.

The researchers want to enroll 5,400 sexually active men and women ages 18 to 35 who do not have HIV, and results are expected in 2020, the NIH said.

"HIV has taken a devastating toll in South Africa, but now we begin a scientific exploration that could hold great promise for our country," study researcher Glenda Gray, president and chief executive officer of the South African Medical Research Council, said in a statement. [27 Devastating Infectious Diseases]

In the Thai study, researchers used two vaccines: one called ALVAC-HIV, which consisted of a bird virus that had been modified to contain three HIV genes, and another vaccine called a protein subunit vaccine, which contained a genetically engineered version of a protein found on the surface of HIV.

The South African study will use these two vaccines, but with some key changes. Both vaccines in the new study have been modified to protect against a subtype the virus known as HIV subtype C, which is found in especially high numbers in South Africa. In addition, the protein subunit vaccine used in the new study will contain a different adjuvant (an ingredient added to a vaccine to boost its effects) than the one used in the Thai study. And the South African study will include a booster shot after one year, with the hopes of prolonging the protective effect, the researchers said.

Participants in the new study will be randomly assigned to receive either the study vaccines or a placebo. If any participants become infected with HIV, they will be referred to local medical staff for care, and will be counseled on how to reduce their risk of transmitting HIV, the NIH said.

Sanofi Pasteur will supply the ALVAC-HIV vaccine, and GlaxoSmithKline will provide the protein subunit vaccine.
• 30 Years Later: AIDS by the Numbers </s> Premier Alden McLaughlin delivered a message supporting World AID’s Day here in the Cayman Islands and congratulating “the excellent work being done by the Health Services Authority, Cayman AIDS Foundation and the Red Cross to educate and inform our people on HIV and AIDS.”

He also said :

“According to the World Health Organization, an estimated 35 million people have died from AIDS-related illnesses since the start of the epidemic in the early 1980s, including 1.1 million in 2015.

“Unfortunately, we in the Cayman Islands are also affected by this global epidemic. Our first case was identified in 1985 and since then 145 people have been confirmed with the virus. Currently there are 39 males and 28 females living here with the disease.”

In 1984 when HIV was found to be the cause of AIDS the US Department of health were reasonably confident they would find a cure for the disease within two years.

“More than three decades later, a safe and effective preventive vaccine has yet to be licensed and more than 250 clinical trials have failed. A large study set to begin in South Africa on the eve of World AIDS day, held on 1 December 2016, is proving to be scientists’ best hope in seven years.” – Léa Surugue

 International Business Times.

Why is it so hard to find a vaccine for HIV? Surugue asks the same question and in her article she says:

HIV is very different from all the other viruses for which a vaccine has successfully been developed. Diseases like polio or small pox have different degrees of morbidity and mortality, but in most people who become infected, the viruses elicit an effective immune response in the body that ultimately clears the virus and protects the person from reinfection with the same virus. Vaccines for the two diseases mimic this protective response.

“Back in the day when there was still small pox, mortality was 15 to 20%. This means that 80 to 85% of people survived and did well in the long term,” said Fauci. “With polio, more than 90% of people ultimately do well. So the body proves that it is capable of mounting an effective immune response.

“Thus, natural infection has provided a ‘proof of concept’ indicating that it is feasible and likely that you will be able to reproduce this natural immune response with a vaccine, based on this successful experiment of nature.”

The problem with HIV is that the body does not easily mount a good immune response against HIV. Among people who are infected, virtually no one goes on to clear the virus or keep it at low level – with the exception of elite controllers who represent less than a fraction of 1% of all HIV infections. This means that to find an effective HIV vaccine, scientists have to do ‘better than nature’.

“When researchers start to think about developing HIV vaccines, they face the problem of having to do better than natural infection. The body does not make a good immune response, and so we have to figure out a way to push the body to create something that it does not readily do naturally. This is why it has been so hard to find a vaccine”, Fauci said.

Read the whole article at: http://www.ibtimes.co.uk/why-it-so-hard-find-vaccine-hiv-1593486

Let us pray the South African vaccine trials prove to be successful although they appear to have only a 31.2% effective at preventing HIV infection over a 3.5 year testing period.

As Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious diseases, one of the trial’s funders, told IBTimes UK: “A vaccine with a 31.2% efficacy is not something you want to widely distribute, but it is enough to encourage you to try and expand upon it.

I leave the final words to our Premier:

“AIDS is a life-threatening illness. Therefore, we must ensure that all of us – young and old – adhere to safe sexual practices. If we do not abide by our own actions to prevent the spread of HIV, the consequences can be grave.

“I also ask that you treat everybody with HIV with respect and compassion. While our health services provide medical care for these persons, we also need to offer our support as a community. We should never stigmatise anyone because they are HIV-positive.

“Finally, as we mark World AIDS Day, please take a moment to remember those whose lives were claimed by this terrible virus. Let us not forget family, friends and neighbours here in the Cayman Islands, and overseas, who died too young, too soon.”

Free HIV testing is still being offered here in the Cayman Islands at a number of locations until Saturday, 3 December.

Free HIV Testing

 Free HIV Testing is available at Faith Hospital, George Town General Practice Clinic and Bodden Town Health Center Monday — Friday from 9am until 1pm and at the West Bay Health Center except on Wednesday. Testing will be available at the East End Health Center on Monday from 1 — 3pm and Tuesday — Friday from 9am until 1pm; at North Side Health Center on Tuesday and Friday from 9am until 1pm and on Wednesday and Thursday from 1 — 3pm; at the AIDS Foundation on Monday and Wednesday from 5 — 7pm and at the Red Cross on Tuesday from 5 to 7pm and on Thursday from 6 to 8pm. Little Cayman clinic offers testing on Tuesday from 9am — 1pm.

To read Premier McLaughlin’s World AIDS Day Message go to: http://www.ieyenews.com/wordpress/premier-and-minister-for-health-hon-alden-mclaughlin-mbe-jp-mla-world-aids-day-message-2016/ </s> London: In a major milestone in the fight against future Ebola outbreak, an experimental vaccine has been found to be highly protective against the deadly virus, as per results of the final trial led by the World Health Organisation (WHO).

The vaccine is the first to prevent infection from one of the most lethal known pathogens, according to the results published in The Lancet journal.

"While these compelling results come too late for those who lost their lives during West Africa's Ebola epidemic, they show that when the next Ebola outbreak hits, we will not be defenceless," said Marie-Paule Kieny, WHO's Assistant Director-General for Health Systems and Innovation, and the study's lead author.

In the most recent Ebola outbreak in West Africa that started in late 2013, more than 11,000 people lost their lives. The WHO removed the global emergency tag for the disease early this year.

The vaccine, called rVSV-ZEBOV, was studied in a trial involving 11,841 people in Guinea during 2015.

Among the 5,837 people who received the vaccine, no Ebola cases were recorded 10 days or more after vaccination.

In comparison, there were 23 cases 10 days or more after vaccination among those who did not receive the vaccine.

The trial was led by the World Health Organization, together with Guinea's Ministry of Health and other international partners.

The vaccine's manufacturer, Merck, Sharpe & Dohme, this year received Breakthrough Therapy Designation from the United States Food and Drug Administration and PRIME status from the European Medicines Agency, enabling faster regulatory review of the vaccine once it is submitted.

The vaccine works by replacing a gene from a harmless virus known as vesicular stomatitis virus (VSV) with a gene encoding an Ebola virus surface protein. The vaccine does not contain any live Ebola virus.

Earlier trials had shown the vaccine to be protective in animals, and be safe and produce an immune response in humans.

Since Ebola virus was first identified in 1976, sporadic outbreaks have been reported in Africa.

But the 2013-2016 West African Ebola outbreak, which resulted in more than 11,000 deaths, highlighted the need for a vaccine.

The trial took place in the coastal region of Basse-Guinee, the area of Guinea still experiencing new Ebola cases when the trial started in 2015.

To assess safety, people who received the vaccine were observed for 30 minutes after vaccination, and at repeated home visits up to 12 weeks later.

Approximately half reported mild symptoms soon after vaccination, including headache, fatigue and muscle pain but recovered within days without long-term effects.

Two serious adverse events were judged to be related to vaccination (a febrile reaction and one anaphylaxis) and one was judged to be possibly related (influenza-like illness).

All three recovered without any long term effects, the study reported. </s> A Canadian-developed vaccine for the Ebola virus has proven to be extremely effective in a full-scale clinical trial, opening the possibility that future outbreaks of the disease can be successfully contained.

The trial, led by the World Health Organization, was staged in Guinea, a country that was ravaged by the Ebola epidemic that swept across West Africa in 2014-2015.

Reporting Thursday in the medical journal Lancet, the study team found that not a single individual among thousands who received the vaccination as soon as they were identified as being at risk of exposure ended up infected with Ebola. In contrast, a control group that was given the vaccine after a three-week waiting period produced 23 infections.

Study leader Marie-Paule Kieny, the WHO’s assistant director-general for health systems and innovation, said the numbers suggest that the vaccine, called rVSV-ZEBOV, is likely to be more than 80-per-cent effective when deployed across an entire population.

“We may very well have a vaccine that will ensure we can control any outbreak,” Dr. Kieny said in an interview from Geneva.

The vaccine is only expected to be effective against the so-called Zaire strain of the virus that was responsible for more than 11,300 deaths in Western African starting in late 2013 – the worst Ebola outbreak in history. A parallel vaccine is still needed for the Sudan strain, which is more prevalent in Eastern Africa.

The clinical trial, which began in March, 2015, marks the first time any vaccine for Ebola has passed the hurdles required for regulatory approval. Other trials that began around the same time foundered because infection rates in Western Africa were dropping too rapidly by then to provide a statistically significant result.

To overcome the dearth of new cases, the WHO team adopted a “ring vaccination” strategy. The approach was originally devised to help shut down the last remaining clusters of smallpox, leading up to its eradication in 1980. During the WHO trial, only those individuals who were close contacts of a new Ebola case, including family members and neighbours, as well as contacts of those contacts, were vaccinated. Whereas members of a randomly chosen West African cohort might only have a minute chance of contracting Ebola , those in the ring of contacts around a new case would be at much higher risk. This translates into a higher confidence level in results of the trial.

“It was a brilliant study design, given the circumstances,” said Frank Plummer, a professor at the University of Manitoba and former scientific director general of the National Microbiology Laboratory in Winnipeg.

Dr. Plummer was running the federal laboratory when scientists there were developing the rVSV-ZEBOV vaccine, based on work by virologists Heinz Feldmann and Gary Kobinger, among others. The vaccine is an altered form of vesicular stomatitis virus (VSV), which affects animals but not people. Thanks to a genetic modification, it carries a surface protein that is identical to one found on the Ebola virus. The protein serves to prime the body’s immune system so that it recognizes and attacks any real Ebola it encounters.

“It’s like a photocopy of Ebola on the outside but with no Ebola on the inside,” said Dr. Kobinger, now the director of Laval University’s Infectious Disease Research Centre. The vaccine is owned by the Public Health Agency of Canada and was licensed to NewLink Genetics, a small U.S.-based firm, in 2010, at a time when there was little commercial interest in developing an Ebola vaccine. It was in turn licensed to the pharma giant Merck in 2014, which produced the vaccine for the trial. Had the Canadian lab not already been developing the vaccine, it would have taken far longer to get to a successful clinical trial so soon after the outbreak.

“We’d been working on it for almost fifteen years,” Dr. Plummer said. “I think it’s a lesson about the value of investigator-driven research.” He added that the VSV virus may turn out to be similarly useful as a platform for creating vaccines against other deadly infections.

Dr. Kobinger said that there were also lessons to be learned that could help global heath agencies respond faster the next time there is an outbreak for which there is no available prevention. For example, had human-safety tests already been conducted on the vaccine, a clinical trial could have been attempted months sooner, while the outbreak was still growing.

Dr. Kieny noted that there remains more work to do on the vaccine yet, including establishing how long it retains its effectiveness. This will be key for health-care workers in high-risk areas who may come to depend on the vaccine for protection.

But, at the very least, the spectre of another uncontrolled Ebola outbreak is receding. With an unusually expressive remark for a scientific paper, the title of the WHO study includes a nod to researchers’ intense desire to bring a terrifying killer to heel.

“Ebola Ca Suffit!” it reads in French. Ebola, enough already.
South Africa launches the HVTN 702 trial for an experimental AIDS vaccine, which will involve over 5,400 men and women over the course of four years.