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When Will There Ever Be a Cure for Ebola?

Africa gets a lot of bad press. Not surprising, really, given all the famines, feuds, and fascist dictators and dysfunctional governments that seem to run many of the continent’s 54 countries. That’s why we were happy to write a positive article on the African agtech startup scene not long ago. Still, there are a lot more problems to overcome than a few flying drones and mobile apps can fix. Africa remains ground zero in the AIDS epidemic where 70% of the worldwide infections are located. It’s also home to the deadly Ebola virus, a highly infectious disease that most Americans probably thought was the name of a synth rock band before it came ashore here briefly in 2014. While health officials have done an amazing job of keeping Ebola from reaching Zombie Apocalypse proportions, the question still remains: When will there ever be a cure for Ebola?

What is Ebola?

First discovered in 1976 near the Ebola River in what is now the Democratic Republic of Congo, Ebola actually refers to a half-dozen viruses within the genus Ebolavirus. Four of these – Ebola virus (or Zaire Ebola virus, ZEBOV), Sudan virus, Taï Forest virus, and Bundibugyo virus – are known to cause the disease in humans. The source of the virus is still a puzzle, but scientists believe one of our fellow mammals is likely responsible, with bats being the prime suspects. Transmission of the disease between people occurs through direct contact (including contaminated objects) with bodily fluids from a person who is sick with or has died from the virus. This occurs through broken skin or mucous membranes in the eyes, nose, or mouth. And those who live in an infection zone may want to stay off Tinder, as the virus also spreads through sexual contact.

Graphic showing transmission of Ebola.

Credit: CDC

Symptoms can take up to three weeks to appear after someone is infected. It’s pretty brutal, starting with fever, fatigue, muscle pain, headache, and sore threat. Then the disease really gets down to business, as those symptoms are followed by vomiting, diarrhea, and a rash, along with kidney and liver problems. In some cases, internal and external bleeding occurs. And for those who do survive – chances aren’t much better than a coin flip – the side effects are nearly as bad: tiredness, muscle aches, eye and vision problems, and stomach pain.

The Impacts of Ebola

While there have been about 20 Ebola outbreaks in West Africa, including as recently as last year, the 2014-2016 outbreak was by far the worst in the disease’s history. There were more than 28,000 confirmed cases during that time period, with more than 11,000 deaths, according to the U.S. Centers for Disease Control. In comparison, there have been 2,427 cases and 1,597 deaths in all other Ebola outbreaks. Considering that 80,000 Americans died from the flu and related complications just last winter, finding a cure for Ebola might not sound like it’s a priority in terms of developing something like a universal flu vaccine.

Map of Ebola outbreaks in Africa over 40 years.

Credit: CDC

However, aside from the devastation on health and communities that Ebola causes, the disease has real impacts on the economies of poor West African nations like Guinea, Liberia, and Sierra Leone. The World Bank estimated that those three countries probably lost about $2.2 billion in GDP as a result of the outbreak:

Economic impacts of Ebola on West African countries.

Credit: CDC

It also said that the epidemic resulted in lower investment, as well as a slowdown in private sector growth and agricultural production in nations where having enough food and nutrition are never sure bets on the best of days. Of course, it doesn’t help when thugs show up and burn down a Doctors Without Borders treatment center.

Economic Incentive for an Ebola Vaccine

There is currently no antiviral Ebola drug licensed by the U.S. Food and Drug Administration (FDA). By now you’ve probably figured out that there’s not much incentive for the private sector to invest R&D into creating a cure for Ebola. Indeed, much of the research, support, and money comes from either philanthropy organizations (Microsoft co-founder famously donated $100 million to the cause) or government agencies like the U.S. National Institutes of Health and the Department of Defense. The U.S. military’s interest, at least in part, revolves around possible bio-terrorism threats.

Ebola Vaccine for Defense

In fact, the DoD gave a biotech company called Arbutus Biopharma (NASDAQ:ABUS), also known as Tekmira, about $140 million to develop a vaccine back in 2010 that was based on the company’s Lipid Nanoparticle (LNP) technology. LNP allows RNAi drugs to be encapsulated in tiny particles made of fats or oils that can travel through the bloodstream to target tissues. Its TKM-Ebola vaccine showed good results in non-human primates and got fast-track approval from the FDA for use in people. It later developed another Ebola vaccine, TKM-Ebola-Guinea, based on the same technology to help combat the West Africa epidemic in 2014-16. We haven’t seen any further news on Arbutus’s Ebola efforts since then, except as a name that appears on sketchy lists for overpriced reports on the Ebola market or bio-defense market.

Click for company websiteAnother biotech company that got a chunk of military coin in 2010 – $291 million, to be exact – for an Ebola vaccine was Sarepta Therapeutics (NASDAQ:SPTA). Its AVI-7537 also showed good lab results but the program reportedly petered out. Instead, the company and its stock are riding high on the news that its RNA-based therapy for treating a form of muscular dystrophy is looking like a winner.

Big Pharma and Ebola

As of June of last year, there have been 36 completed trials on Ebola vaccines, along with seven active clinical trials and another seven recruiting participants for study. Scientific consensus is that the most promising vaccine in development today actually belongs to Merck and Co. (NYSE:MRK). V920 was initially engineered by scientists at Canada’s National Microbiology Laboratory before a biotech company called NewLink Genetics Corporation (NASDAQ:NLNK) licensed the technology, which Merck acquired for a reported $50 million. Merck is now in the process of getting the vaccine approved by the FDA, and NewLink itself stands to make some more money if the application is successful.

Study volunteer receives an Ebola inoculation at Redemption Hospital in Monrovia, Liberia.

Study volunteer receives an Ebola inoculation at Redemption Hospital in Monrovia, Liberia, in 2017. Credit: NIAID

Such breakthroughs are rarely the work of one scientist or even one team of researchers. In the case of V920, some of the heavy lifting actually began more than 15 years ago when scientists re-engineered a virus called vesicular stomatitis virus (VSV) that provided insights into how Ebola invades host organisms and uses their cells for viral reproduction. It also suggested a possible candidate for a vaccine. The results, published in the July 2005 issue of Nature Medicine, were largely ignored until a few First Worlders got infected in 2014.

Other big drug makers like Johnson & Johnson (NYSE:JNJ) and GlaxoSmithKline (NYSE:GSK) have also been working on Ebola vaccines. Despite the apparent success of the Merck vaccine, the battle against Ebola isn’t over, given that there are multiple variations of the virus and other considerations when it comes to developing these sorts of vaccines.

Other Possible Cures for Ebola

Click for company websiteFounded in 2003, San Diego-based Mapp Biopharmaceutical has long been at the forefront of developing an Ebola vaccine, gaining some fame during the 2014-16 epidemic. Working with academic and government researchers – including the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), which helped pioneer the VSV research behind V920 – Mapp just published new research on how a cocktail of monoclonal antibodies (mAbs) protected animals from three Ebola viruses known to infect humans. We’ve written previously about how mAbs are used for certain cancer immunotherapies by designing antibodies that help a patient’s immune system fight the disease.

Click for company websiteLike Mapp Biopharmaceutical, Regeneron Pharmaceuticals (NASDAQ:REGN) has developed a cocktail of three monoclonal antibodies as a possible Ebola vaccine. The product, REGN-EB3, was shipped to the Democratic Republic of Congo last year during the recent Ebola outbreak there. The vaccine is the result of the company’s “proprietary VelociSuite technologies that facilitate rapid identification, validation and development of suitable antibody candidates to address urgent public health needs by moving from preclinical to clinical research in a matter of months instead of years.”

Profectus drug pipeline for Ebola and other infectious diseases.

Profectus drug pipeline for Ebola and other infectious diseases. Credit: Profectus

Founded in 2002, Baltimore-based Profectus Biosciences has raised about $35 million in both venture capital and government grants through 2015, though the private biotech company has taken in millions more in grants since then. Profectus is developing a number of vaccines targeting different infectious diseases like Ebola, Marburg, and Lassa. Marburg and Lassa are also hemorrhagic fever viruses. The former is similar to Ebola, while the latter is transmitted to humans after contact with food or other items contaminated with rodent poop. Profectus’ VesiculoVax delivery platform amplifies the B-cell immune response needed to protect against these viruses, and it has shown single-dose protection of monkeys.

Click for company websiteSoligenix (NASDAQ:SNGX) out of New Jersey has partnered with Hawaii Biotech to develop a vaccine for both Ebola and Marburg. The big twist here is that the companies, along with the University of Hawaii, are working on a vaccine that does not need to be refrigerated like most of the other Ebola vaccines that use VSV techniques, which involve live but attenuated versions of the virus. Soligenix has developed a vaccine thermostabilization technology, ThermoVax, to stabilize components of the vaccine, which is based on purified recombinant protein antigens. Antigens, most of which contain proteins, are foreign substances that induce an immune response. A recombinant antigen is one that has been artificially created, making it easy to mass produce. The Hepatitis B vaccine is probably the most successful example of using recombinant antigens.

Conclusions

The simple answer to the question of when will there be a cure for Ebola seems to be any day now. But new variations of the virus, and emerging threats like Marburg and Lassa, mean there’s no end in sight to the war against these hemorrhagic fever viruses until we can possibly develop a universal vaccine. While it might be easy to dismiss Ebola and the rest as Third World problems, we saw back in 2014 that their problems can quickly become our problems.

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