Experimental Ebola Vaccine Reveals a Market Solution in the Developing World

August 27, 2019   Robert Gmeiner

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An ongoing Ebola outbreak in the eastern Democratic Republic of the Congo (DRC) has claimed more than 1,000 lives and the death toll is rising. Ebola is highly contagious and often fatal but, like many illnesses caused by viruses, has the potential to be prevented by vaccines. Public health infrastructure in the developed world makes it unlikely for an outbreak to occur if the virus should arrive there. In poor, developing countries in Africa, outbreaks have happened repeatedly. Because the market for an Ebola vaccine is concentrated in poor areas, expensive research to produce a vaccine has progressed slowly.

Vaccines offer a steady revenue stream for vaccine makers once they are developed. The cost to develop a vaccine and the infrastructure needed for mass production is so prohibitive that generic vaccines are almost unheard-of. Although there is constant demand for vaccines, pharmaceutical companies generally research vaccines that have a market in wealthier countries. Vaccines administered in childhood for disease such as measles, polio, whooping cough, and many others have existed for a long time. More recently, new vaccines have been developed, but not for things that plague the developing world. Pharmaceutical companies have instead focused on older individuals in developed countries by producing drugs for HPV and shingles.

An article and accompanying video produced by CNBC entitled “Merck’s Ebola vaccine helps combat deadly outbreak in the Congo as the virus spreads” describes this dynamic of vaccine research, production, and distribution. Most of the research on vaccines for the developing world has been philanthropically funded. Merck’s work on the Ebola vaccine is a unique outlier. The experimental Ebola vaccine is not approved for general use, but it is being distributed because the benefits outweigh the high human cost of the disease among health workers and individuals in affected areas.

Merck’s Ebola vaccine was developed in the mid-1990s by scientists in the United States and Canada and produced at the National Microbiology Laboratory in Winnipeg, Manitoba, Canada. The vaccine research was published in Nature Medicine and the researchers thought it could be on the market by 2010 or 2011. It was not brought to market because of the high cost and small market. Had approval progressed as the researchers first hoped, the Ebola outbreak in west Africa in 2014 could have been prevented or at least mitigated, along with the current outbreak. Instead, these outbreaks, which are far larger than outbreaks during the 1990s, have only rekindled interest in the vaccine, which was licensed to Merck and is now being used experimentally.

Markets have an excellent track record of solving problems. Vaccines for fatal diseases were developed long ago. Today’s costs are, in many respects, imposed by government. Onerous drug approval regulations and expensive clinical trial requirements serve a purpose, but they also eliminate market forces. Clinical trials in humans for an Ebola vaccine are an enormous undertaking given the risk of infection with a disease that has a fatality rate that is almost 50%. The experimental vaccine is now being used in Africa and trials are under way there. Merck’s experimental vaccine use shows that, when artificial cost barriers are reduced, market forces can work. This writing does not advocate for eliminating beneficial drug approval requirements or for widespread use of unproven drugs. Rather, it shows that the forces preventing certain drugs from reaching the developing world result from government action at least as much or more than the market.