Guest Africa Podcast Podcast

Ebola control in the DRC: "No pressure in the choice of vaccines" (Head of the Riposte)

Just a year ago, the Ebola virus was making its first victims in eastern DRC. A year later, the virus continues to wreak havoc: there are now three epicenters in North Kivu and Ituri. 1,790 people died of the disease. The scale of the problem is such that the World Health Organization has elevated this epidemic to "a public health emergency of international concern ". On a daily basis, the teams fighting this epidemic are facing mistrust of the population, insecurity ... and problems of transparency. Professor Jean-Jacques Muyembe, the discoverer of the first Ebola virus in the DRC and leader of the Ebola Response against our guest.

You say that the Ebola outbreak has lasted too long. Why ?

Jean-Jacques Muyembe : This epidemic started in two provinces that have never been in contact with this virus. So the people do not know anything about Ebola. It is very difficult for her to accept the presence of the virus in her communities. And so, if it does not engage, it is difficult to control this outbreak.

In addition, this virus has spread to a population that has long been traumatized by the armed conflict. It is a population that does not trust the political staff. The presence of armed groups makes the response very difficult. Because when you follow a contact and it is hidden in areas controlled by armed groups, it's almost impossible.

It is currently the vaccines manufactured by Merck Laboratories that are administered to patients. How many people have been vaccinated until today ?

More than 170,000 people have been vaccinated.

So far, has this vaccine been effective?

Yes. So far, initial analyzes show that this vaccine can provide over 90% protection. So it's a relatively effective vaccine.

Resigned last week, the Minister of Health, Dr. Oly Ilunga, denounced pressures from all sides including to impose a second vaccine, proposed by Johnson & Johnson laboratories. What was your role in the debates that led to the promotion of this second vaccine to the Congolese authorities?

This is a false debate. Because initially, our vaccination strategy was to be advised by the group called Johnson & Johnson, which advises the World Health Organization (WHO) on vaccination. And at its meeting on July 7, this group proposed, first, to readjust the dose, because there was a possibility of shortage.

The second recommendation is that it is imperative to introduce a second vaccine of a preventive nature. At INRB (National Institute of Biomedical Research), we looked at the candidate vaccine study and found that there were three vaccine candidates we could use. There is the Russian vaccine, the Chinese vaccine and the Johnson & Johnson vaccine. And our choice fell on the latter, because it was a vaccine that had accumulated a certain amount of data. But there was no pressure, neither at our level nor at the level of the minister to choose or take the vaccine. It was really a problem of scientific choice, based on scientific dividends, to take this or that vaccine.

Is this second vaccine produced by Johnson & Johnson Laboratories currently being used by patients for prevention?

No, no ... We have not used it yet because we have to make a decision now. This must go through the National Study Committee and this must also go through the DRC's National Regulatory Authority. We respect the opinions of the ethics committee according to a protocol. It's a study. It is not a vaccination that we will do routinely.

You are both the director of the Biomedical Research Institute of the DRC, the head of the response and the focal point of the major consortia for experimental treatments and vaccines. Are you able to guarantee to the Congolese that there will be no conflict of interest?

There is no conflict of interest because we are there simply as scientists. I do not win anything for that.

And who controls your work?

These are the ethical committees and then an international consortium.

Some press articles have reported a somewhat excessive pace. The purchase of brand new SUVs, the money flowing freely ... Which has, in a way, also targeted the populations. How is the money from the riposte managed?

We are discussing. Normally, it's managed at the departmental level. But there are, in any case, international organizations that are involved. For the moment, we have problems because most of the DRC staff, the Congolese who are there, are not paid. They have arrears of three-four months. So these are issues that we have to quickly solve to get back on the ground, because most people are unmotivated because of that. So you have to start again.

So there is an internal problem with the money management of the response and the compensation of the teams on the ground. How to redistribute this money to the program on the ground?

The World Bank has given a fairly large supply. We will now see how we can pay the arrears and restart the response.

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