The vaccine-development response to the 2014 Ebola epidemic in West Africa, though a valiant effort, was too little, too late. Three vaccine candidates were tested successfully under challenging conditions.1-3 Governments and foundations mobilized funds quickly. Companies and research-and-development institutions brought vaccine candidates into the field. Collaborations among the World Health Organization (WHO), funders, academia, civil society, and industry saw vaccines advancing through more than 15 accelerated clinical trials in a year. But the testing of Ebola vaccine candidates had previously stalled, though several candidates could have been ready for efficacy testing before the epidemic if the necessary investments had been made. In the absence of data on safety, immunogenicity, and dosing in humans, it was challenging to progress quickly with efficacy trials in West Africa. As a result, people who could have been protected instead became infected, and too many of them died. Moreover, there is no guarantee of similar risk-taking efforts in the future, especially given the poor market potential and the great clinical and regulatory uncertainties.
Vaccines can prevent outbreaks of emerging infectious disease from becoming humanitarian crises. The WHO recently deemed 11 pathogens as the most likely to cause severe outbreaks in
the near future and will regularly update its list There are feasible vaccine candidates for some of these diseases. When such candidates exist, timely vaccine development can avert global public health emergencies, contain loss of life, and limit social and economic damage.
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