WHO Prioritizes Experimental Treatments for Bundibugyo Virus Outbreak

The World Health Organization (WHO) has officially recommended the prioritization of three experimental treatments for the Bundibugyo virus disease (BVD), a strain of Ebola currently causing an outbreak in the Democratic Republic of the Congo and Uganda. As there are currently no approved vaccines or therapies specifically for this virus, health officials are moving to accelerate the evaluation of these candidates within clinical trials.

Prioritized Therapeutics for Treatment

Following a review by the WHO Research and Development (R&D) Blueprint Technical Advisory Group, experts have identified three therapeutic candidates for clinical research. These treatments are intended to address the urgent need for effective medical countermeasures during the ongoing public health emergency:

• MBP-134: A monoclonal antibody developed by Mapp Biopharmaceutical, which has shown promising neutralizing activity and efficacy in animal models.
• Maftivimab: A monoclonal antibody developed by Regeneron. According to the company, supplies of this treatment are already available in the Democratic Republic of the Congo for potential use or study.
• Remdesivir: An antiviral drug developed by Gilead Sciences that has demonstrated antiviral activity and supportive preclinical evidence.

The WHO advisory group has recommended that these treatments be evaluated in clinical trials to generate essential safety and efficacy data. Advisors also suggested that researchers investigate combination therapies, such as pairing a monoclonal antibody with remdesivir.

Focus on Post-Exposure Prophylaxis

In addition to active treatment, the WHO has prioritized the oral antiviral obeldesivir for clinical evaluation as a post-exposure prophylaxis (PEP). This approach aims to prevent the development of the disease in individuals who have had contact with confirmed cases. Experts emphasize that the effectiveness of this strategy will rely heavily on robust contact tracing efforts.

Vaccine Development Landscape

While the search for effective treatments is underway, the development of vaccines for the Bundibugyo virus remains in the early stages:

• rVSV Bundibugyo: Developed by the International AIDS Vaccine Initiative, this single-dose candidate is considered highly promising, though it is not expected to be ready for trials for seven to nine months.
• ChAdOx1 Bundibugyo: Developed by Oxford University and the Serum Institute of India, this candidate could potentially be available for testing in two to three months, provided that additional animal data requirements are met.

The WHO also evaluated Merck’s Ervebo, the only currently licensed Ebola vaccine. However, the agency advised that it should not be used outside of research settings, as current evidence regarding its protection against the Bundibugyo virus remains limited and inconclusive.

Key Takeaways

• There are currently no vaccines or therapies specifically approved for the Bundibugyo virus.
• The WHO is prioritizing MBP-134, maftivimab and remdesivir for inclusion in clinical trials.
• Obeldesivir is being prioritized for post-exposure prophylaxis to protect contacts of confirmed cases.
• Vaccine candidates are currently in development, with the earliest potential trial testing expected in the coming months.

As the outbreak continues, the international health community remains focused on generating rigorous clinical data to ensure that any deployed medical countermeasures are both safe and effective for those affected by the virus.