When Ebola swept through three countries in Africa in 2014, the medical community had few ways to prevent, treat or test for this deadly, highly contagious disease. With little incentive for people to seek care, it was difficult to track the disease’s transmission and isolate people who fell ill, leading to more than 11,000 deaths.
Since that grim time, the prospects for containing Ebola have brightened remarkably. Under the leadership of David Boucher, John Lee and Dan Wolfe from the Biomedical Advanced Research and Development Authority, vaccines, therapeutics and diagnostic tests for Ebola were manufactured and approved for use, and can now be sent quickly to where they are needed.
Boucher and Wolfe, both branch chiefs at BARDA, and Lee, a health scientist at the agency, lead groups that make up the authority’s Ebola MCM (Medical Countermeasures) Task Force Team.
The process for developing and manufacturing the Ebola medical products under BARDA’s watch was extraordinarily quick. “I don’t think I can stress enough how incredible it is to go from where we were in 2014, of not having anything other than investigational products that had shown potential efficacy … to where we are today,” said Gary Disbrow, the director of BARDA.
The agency, located within the Department of Health and Human Services, helps protect the nation from chemical, biological, radiological and nuclear threats, pandemic influenza and emerging infectious diseases—contributing funding, technical expertise, research and more to help companies develop products for which there is no commercial market.
“It’s just an amazing amount of work, and it was a collaboration, but these three individuals were key to that success,” Disbrow said.
By the time another Ebola outbreak occurred in 2018, products developed with BARDA’s support received emergency use authorizations and, in 2020, a vaccine, two therapeutics and a diagnostic test received Food and Drug Administration approval. A second vaccine was also approved by the European Union.
Dr. Christopher Houchens, director of BARDA’s Division of Chemical, Biological, Radiological, and Nuclear Medical Countermeasures, said, “The bumper sticker is that the U.S. and the world are prepared now to respond to Ebola outbreaks and Ebola pandemics.”
When Ebola flared yet again in Guinea and the Democratic Republic of Congo in January 2021, Boucher and the team worked with the National Security Council and the White House to determine the available amounts of vaccine, therapeutics and diagnostics. They then facilitated and confirmed the shipments and distribution of those products, getting them to Guinea fast enough to treat seven people, all of whom survived, and ensuring BARDA-supported medical countermeasures already in the Democratic Republic of Congo were sufficient to meet the demands of the country’s 12th Ebola outbreak.
Two months later, the number of Ebola infections had hardly reached the double digits, few people had died and the countdown to declare the outbreak over in the Democratic Republic of Congo was halfway done and expected to start soon in Guinea.
Houchens credited the team’s leadership with supporting companies that help the U.S. respond to outbreaks. He said that Boucher has the “sheer will and persistence” for getting products developed and that Lee’s strength as an engineer was “absolutely critical for driving the development of novel diagnostics for threats like this.”
Houchens called Wolfe “one of the most gifted scientists in BARDA” who has long experience developing vaccines for biothreat agents and emerging infectious diseases like Ebola.
The Ebola work had its challenges, said Linda Lambert, director of Medical Countermeasures Program Support Services. The three team leaders had to “keep plugging away, resolve issues, work with the companies and gather the resources,” she said. “It showcases their commitment and passion for public service.”
They also had to work on overcoming skepticism of modern medicine in African countries and get buy-in from public health officials there. In addition, the BARDA team contracted with the biotechnology company Regeneron to make an Ebola therapeutic that was not initially included in a clinical trial in the Democratic Republic of Congo. Team members had to convince U.S. and international partners to include it in the mix.
“It was a lot of effort to make that happen,” said Danielle Turley, regulatory affairs branch chief at BARDA, and Boucher “did a lot of the heavy lifting.”
Boucher said the Regeneron therapeutic was “a product we thought could be groundbreaking and really turn the tide of an outbreak.”
Reflecting on BARDA’s Ebola work, Boucher recounted the story of baby Nubia, born infected to a mother who died of Ebola days later. Treated with an early-stage product manufactured under a contract Boucher negotiated, baby Nubia is now about six years old.
Boucher struggled to maintain his composure as he recalled visiting the Ebola treatment unit where baby Nubia was cared for, a year later. A whiteboard with her final infusion schedule remained on the wall—a sign of a victory that stemmed from treatments BARDA had worked on.
“It’s really just the work BARDA does,” he said.