KINSHASA (Reuters) – When the city of Mbandaka in northwestern Congo was hit by Ebola in 2018, health officials had to act swiftly – the city was connected through a regular boat service to the major the sprawling city of Kinshasa, where the deadly virus could spread out of control.
Unlike previous outdoor events, they had a new weapon – an experimental vaccine that could reverse the fight against Ebola – if they could keep the filters between minus 60-80 degrees Celsius in tropical humidity and over rough terrain.
As the world embarks on an unprecedented campaign to deliver ultra-cold COVID-19 vaccines to billions in remote areas, the Democratic Republic of Congo’s experience holds crucial lessons in disseminating vaccinated and trusted by those who receive it.
Congo itself aims to use the local technology and knowledge to get its people vaccinated against COVID-19. The country has recorded more than 15,000 cases and 369 deaths from the virus, and it has a second wave of infections.
Between 2018-20, health workers infected more than 400,000 people in three Ebola uprisings, dragging valves colder than Antarctic winter over warm forests and on muddy mountain roads. When cars could not pass, they drove motorcycles. If water was the only way, they used a coracle.
“These roads are often flooded during the wet season. Many times you have to cross rivers that do not have bridges, ”said John Johnson, vaccine and emergency response consultant for the French medical charity Medecins Sans Frontieres (MSF).
This was the largest ever release of an ultra-cold chain vaccine, a spokesman for GAVI, an alliance of governments, drug companies and charities that organize global vaccination campaigns, said.
In Mbandaka, a full-scale crisis has been halted. In the vaccine, and well-drilled health protocols, the virus was present.
GIANT THERMOS
There was a high-tech detachable thermos that could fit on a motorcycle or in a canoe and kept cool filters for a week – essential in the Congo where less than one in 10 people have access to electricity.
The Arktek machine works as a large coffee thermos that can be filled with hundreds of vaccines, and special ice packs made of different materials.
Produced in China by Aucma and selling for around $ 2,300 per unit, it was developed in 2014 to store polio vaccines at 2-8 degrees Celsius, and was converted when the Merck Ebola vaccine was approved for used in Guinea and Sierra Leone at the 2013-16 revolution.
“Like most thermoses designed to keep your coffee hot or cold drink cold, they use bleach to protect the product from the environment,” said Daniel Lieberman of Global Health Labs (GHL) , a non-profit research organization created by the Gates Foundation that helped design it.
In Congo, they found the best ice packs using salt water, which kept the vaccine frozen for up to a week without power.
Health teams in Congo set up a network of deep freezers from which the Arktek was used. That helped healers reach remote areas and end a disease in the east that killed more than 2,200 people in two years, the second worst Ebola outbreak in history.
GHL is now restoring the Arktek for use with dry ice, which can keep up to 1,500 doses of the Pfizer-BioNTech COVID-19 vaccine frozen for several weeks.
AFTERNOON PRAYER
Advances in cold chain technology mean little if health workers do not earn public trust and dispel misinformation about vaccines.
WHO officials say that, during the 2018-20 Congola Ebola uprising, they made a mistake in not hiring local health workers.
Rumors are circulating that the vaccine would make men weak, infertile women and children less sensitive. More than 300 attacks on health workers have been recorded, leaving six dead.
“They need to understand what they are getting and the risks and benefits. The mistake that is often made is to water the message and make it too simplistic, ”said Johnson at MSF.
The WHO only used local health care workers to spread the vaccine in a western uprising, which ended in six months with 55 deaths.
Vaccine suspicion is not limited to central Africa. A 2018 study of 140 countries by London-based medical charity Wellcome Trust found that in low-income sectors there is higher confidence that vaccines are safe than those with incomes high.
One-third of people in the UK say they have seen messages discouraging the public from getting a coronavirus vaccine, according to a study by King’s College London and British research firm Ipsos MORI.
Doubts must be addressed now, before major COVID-19 vaccination campaigns begin, said Touré Alhassane, who led the WHO vaccine rollout at Congo’s latest Ebola uprising, which ended in the United States. November.
“Even if you have all the money in the world, and you have everything you need to put it into action, if the community is not with you, you are not going to succeed, ”he said.
Reporting and writing by Hereward Holland; Edited by Edward McAllister and Ed Osmond