Ebola, help from Israel.
(photo credit: SHIRA BEN TZION)
The 2014 Ebola epidemic in West Africa caught many global leaders and policymakers by surprise.
The world was slow to mount the massive response needed to get the majority of Ebola patients treated in a hospital or hospital-like setting, and ensure that burials were conducted in a quick and safe manner.
After a multinational surge that included Israeli medical teams and the United States military, the epidemic was finally contained, but only after more than 11,000 people lost their lives.
The Ebola epidemic exposed vulnerabilities in our global response capabilities to public health emergencies, including our ability to make new technologies such as vaccines available. A tragic situation unfolded in which prototype Ebola vaccines had been developed in US research laboratories five to 10 years ago, and yet there were minimal efforts to manufacture and then test and stockpile in order to have these vaccines available for the 2014 epidemic. The major pharmaceutical companies did not venture into neglected tropical disease drugs and vaccines because they were not profitable. Only at the eleventh hour, when the Ebola epidemic began showing pandemic potential, did the US government make financial investments in Ebola vaccines and the big drug companies become engaged. However, by then the epidemic had mostly ended.
One reason Israeli science should take note of these shortcomings is the vulnerability of the Middle East and North African region to lethal epidemics of neglected tropical diseases. Although we designate such infections as “tropical” the truth is that diseases such as Ebola emerge primarily in the setting of extreme poverty together with breakdowns of public health infrastructure linked to conflict or post-conflict.
Every indication suggests that this perfect storm of poverty and conflict is now happening in places such as Libya, Yemen, and Islamic State--occupied Syria and Iraq.
While it is unlikely Ebola will emerge in the Middle East and North Africa, there are a half-dozen or more neglected tropical diseases that may arise. They include diseases transmitted by insects, such as leishmaniasis, malaria, and arbovirus infections, as well as the MERS coronavirus infection.
Because of low or non-existent profit margins, the multinational drug companies will not invest in vaccines for most of these diseases, but there is potential for vaccines to be developed in the non-profit sector. Israel boasts the highest-ranked research universities and institutes in the Middle East, so we could look to them for taking leadership in global health vaccines. However, they may not have the product development infrastructure to do this alone. Instead Israel has the opportunity to collaborate with more than a dozen so-called product development partnerships – PDPs – which are international non-profit organizations that use industry practices to make neglected disease drugs and vaccines.
One example is the product development partnership between our Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development, now developing neglected disease vaccines for war-torn areas.
A joint collaboration with research organizations based in Israel, possibly together with a local biotech, could lead to indigenous production of a variety of new global health technologies. Such life-saving products would serve more than Israel’s enlightened self-interests; they could also be used to launch scientific collaborations with research institutes and universities in Arab countries across the Middle East and North Africa.
Partnerships could include the Weizmann Institute of Science and Israel’s major research universities. They could expand on Israel’s existing global health commitments in international health education at Ben-Gurion University and a new but modest “grand challenges” initiative in global health technologies through the Canadian Government.
In the late 1950s, Dr. Albert Sabin developed the oral polio vaccine jointly with Soviet scientists in order to combat a shared infectious disease threat. Dr. Sabin ultimately became Weizmann Institute president during the 1970s. Israel now has a similar opportunity to engage in producing biotechnologies to combat infectious disease threats that will almost surely emerge in conflict-ridden Syria, Iraq, and Libya and ultimately advance to threaten Israel and the entire region.Peter Hotez MD PhD is president of the Sabin Vaccine Institute and dean of the National School of Tropical Medicine at Baylor College of Medicine, in Houston, Texas. He is also the US State Department Science Envoy for the Middle East and North Africa.