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In an urgent bid to combat the latest Ebola outbreak in the Democratic Republic of the Congo (DRC), health officials have initiated a groundbreaking treatment trial just six weeks after the World Health Organization (WHO) declared the situation a public health emergency on 17 May. With mortality rates soaring amidst a lack of approved treatments, the trial aims to evaluate the effectiveness of two promising drugs—remdesivir and MBP134—offering hope to affected communities in the Ituri province.
Swift Action in a Time of Crisis
The trial, named Partners, is notable for its rapid establishment, an accomplishment that has been applauded by scientists and health professionals alike. As of 9 July, the outbreak had resulted in 1,792 confirmed cases and 625 fatalities due to the Bundibugyo strain of the virus, which is particularly concerning as it currently lacks both a vaccine and effective treatment options. The situation is dire, with the WHO reporting that the outbreak is still “in the expansion phase.”
Residents of Bunia, the capital of Ituri, have expressed their frustration at the slow pace of interventions. Neema Haba, a local mother and banana seller, voiced her concerns, stating, “I hope these drug trials proceed quickly. Financially, we are being driven to the brink by this outbreak, and nothing is going right. We are struggling to provide for our children.”
Challenges on the Ground
The response to the outbreak is complicated by various challenges, including community distrust of authorities and a highly mobile population. Despite efforts to trace approximately 75% of known contacts, frontline workers have faced significant hurdles, including protests due to lack of pay. Ovide Maliabo, a driver for a burial team, highlighted the dangers they face, saying, “It’s a shame that we aren’t being financially supported,” after recounting a near-lynching incident.
Moreover, the necessary equipment for safely handling Ebola victims, such as protective gear and transport vehicles, is in short supply. Bahati John, a team leader, lamented the lack of financial compensation since their work began on 15 May, stating, “We are the breadwinners of our families, and our families are suffering.”
Promising Treatments in the Trial
The Partners trial will involve random assignment of patients to receive either remdesivir, MBP134, a combination of both, or standard supportive care. Remdesivir, an antiviral developed by Gilead Sciences, has shown effectiveness against various viruses, while MBP134 is a monoclonal antibody designed to neutralise the Ebola virus. Both treatments are administered intravenously—MBP134 as a single infusion and remdesivir over a ten-day period.
Professor Laurens Liesenborghs from the Institute of Tropical Medicine in Antwerp has indicated that both drugs have demonstrated efficacy against the Bundibugyo strain in animal studies. “Basically, what we want to see is if they indeed can lower mortality,” he explained. Historically, Bundibugyo has a lower mortality rate than the more infamous Zaire strain but still poses a significant threat, claiming around one-third of those infected.
A Collaborative Effort for Global Health
The trial design allows for the inclusion of additional treatments should new options become available. With an estimated 700 to 1,000 patients needed for robust statistical analysis, the speed at which these sites are being established is crucial. WHO officials have confirmed sufficient supplies of both drugs for up to 1,200 patients, with assurances of continued availability post-trial if the treatments prove safe and effective.
Inclusivity is a key feature of this trial, allowing participants of all ages, including pregnant and breastfeeding women—groups often sidelined in medical research. Professor Amanda Rojek, the international principal investigator for Partners from the University of Oxford, praised the quick start of the trial compared to previous outbreaks, crediting strong scientific leadership within the DRC.
As the trials progress, the hope is to decrease the death toll and alleviate the widespread fear gripping the local population. “What limits an outbreak is our capacity to provide care, our surveillance capacity, and our ability to isolate people,” remarked Professor Yap Boum from the Africa CDC.
Why it Matters
The success of these treatment trials could mark a significant turning point in the global fight against Ebola, particularly for regions grappling with recurrent outbreaks. By swiftly delivering potentially life-saving treatments, the Partners trial not only aims to save lives but also to restore trust within the affected communities, sending a powerful message of hope and resilience in the face of a devastating public health crisis.
