If there's a licensed Ebola vaccine sitting in a stockpile, why aren't more health workers in Congo getting it? That's the question Doctors Without Borders put to the World Health Organization on Monday, and it's where we begin. This is Ebola Watch for Tuesday, November 10th. After that, Kenya's health minister gives a new patient count as the country waits to start its 42-day clock.
From a Médecins Sans Frontières statement released Monday, November 9th:
In August, the DRC government, with support from Africa CDC, requested 500,000 doses of ERVEBO® from the World Health Organization's International Coordinating Group (ICG) on Vaccine Provision to support a broader vaccination strategy. Only 70,000 doses were released.
Seventy thousand out of half a million. But remind me, Ervebo wasn't made for this virus, right? Correct. Ervebo is licensed against the Zaire species of Ebola. This outbreak is Bundibugyo, which has no licensed vaccine or treatment. MSF says animal studies and immune data from vaccinated people suggest Ervebo's response may also recognize Bundibugyo. And its epidemiologists report what they call encouraging field signals: fewer confirmed cases, and indications of lower mortality, among people who were vaccinated in earlier Congo outbreaks. That sounds promising. How solid is it? It's early. CIDRAP describes the field observations as anecdotal, and none of this is a trial result. The Tumaini trial in Bunia is designed to answer that question, and WHO has said it hopes for interim results in early 2027. So what exactly is MSF asking for? It wants WHO's Strategic Advisory Group of Experts on Immunization, known as SAGE, to lift the restrictions that tie Ervebo to research protocols. Right now, MSF says, frontline workers get it through research or compassionate-use routes, and contacts of confirmed cases mostly only through trials. SAGE meets next Tuesday, November 17th, and MSF says a larger release of doses depends on that meeting. It's also asking Merck and global health partners to match allocations to the need. This is the thing that gets me. The vaccine exists, it's licensed for anyone a year and older, and the bottleneck is paperwork and supply. MSF says kids under twelve could wait even longer for a Bundibugyo-specific shot. Every month counts. That's MSF's argument too. Its deputy director of operations, Guyguy Manangama, says every month spent waiting leaves health workers and contacts exposed. Epicentre's Etienne Gignoux puts the other side of it: health authorities have to weigh the need for research against the need to save lives. MSF also stresses that vaccination has to sit alongside tracing, care and safe burials, not replace them. And where do the numbers stand? CIDRAP's Monday report gives 10,910 confirmed cases and 5,234 confirmed deaths in Congo, a crude case fatality ratio of 48.7 percent. It doesn't say what date that data runs to. WHO's last update, with data to November 3rd, had 10,668 confirmed cases.
Michael Omondi, reporting for the Kenya News Agency on Health Cabinet Secretary Aden Duale's meeting with a WHO delegation:
“Kenya has recorded nine cases linked to a single transmission cluster, with no evidence of community transmission. Six patients have recovered and been discharged, two have died and one remains under treatment,” reported Duale, adding that more than 772,000 travellers have been screened at 28 points of entry, 736 samples tested across five designated laboratories, and over 7,300 healthcare workers trained.
Six recovered. On Monday we had five. Right. WHO's update, which we covered yesterday, said five patients were discharged on November 3rd and two were still in treatment. Duale now says six have recovered and one remains in care. Neither report says when that sixth discharge happened. Kenya has gone three straight weeks without a new confirmed case. So is the 42-day countdown running yet? Not yet. According to Duale, it starts once the last patient is discharged, and then Kenya needs 42 days with no new confirmed infection. Separately, WHO said the last 52 contacts are due to finish monitoring tomorrow, Wednesday. WHO's Regional Director for Africa, Yakub Janabi, led the delegation, and the two sides agreed to monitor the countdown jointly and coordinate the end-of-outbreak declaration. What about the travel bans? Those have been hanging over Kenya for weeks. Duale raised them directly. The Standard quotes him saying countries that report outbreaks transparently should be supported, not penalised, and he asked WHO to push for measures consistent with the International Health Regulations. WHO also donated 12 portable PCR systems and a 28-bed Ebola treatment unit, and Kenya asked for more test supplies and training. For anyone flying to Nairobi this month, nothing he said changes the official advisories. The ones we've reported on, like Saudi Arabia's ban and the U.S. Level 3 notice, haven't been lifted in anything we've seen. Agreed. The minister's account is the clearest sign yet that Kenya's cluster is closing out, but the official end has to wait for the clock.
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Tomorrow we'll look for word on whether Kenya's last contacts have cleared monitoring, and anything new ahead of next week's vaccine advisers' meeting. Ebola Watch comes to you from Lantern Podcasts. Back with you Wednesday.