Gates Package — page 81

To: Collins, Francis (NIH/OD) [E] Subject: FW: Support on Ebola We should discuss how we are going to respond to Trevor From: Trevor Mundel [mailto gatesfoundation.org] Sent: Thursday, August 07, 2014 7:17 PM To: Collins, Francis (NIH/OD) [E]; Fauci, Anthony (NIH/NIAID) [E] Subject: Support on Ebola Dear Francis and Tony, It is clear that the problem, concern and media attention surrounding the treatment of the two individuals now in Atlanta add further weight to the Ebola outbreak concerns, which we have discussed by email over the past week or so. Although the overall burden of disease due to Ebola is not of the magnitude of the conditions we address strategically, we recognize that the current situation calls for action and places considerable pressure on your agency and WHO and others of our key partners. For these reasons we have provided emergency funds to WHO and UNICEF to support public health measures as well as on the ground human resources in the target countries as one in kind contribution to the problem. We would also like to be supportive of your efforts, if doing so can add value. One challenge is that we believe that interventions that could help to interdict the current epidemic are needed the most. Interventions that are not ready to give to patients in the relatively near term will not be of help for this emergent situation. We understand that there are efforts with GSK and the VRC to scale up the lot of the ChAd3 vaccine, which is due to go into FIH studies this fall and for which additional doses might be available for evaluation in at risk individuals by early 2015; we believe that Wellcome may be interested in supporting this effort. We also understand that there are very limited supplies of ZMapp (~12 courses of therapy). Assuming an appropriate approach can be designed with input from relevant stakeholders (i.e., one which provides for equity in opportunity for participation in an interventional trial that extends beyond foreign health workers to include indigenous individuals), we would be willing to assist with partial funding to generate more product in partnership with NIH and other relevant agencies. We can also provide in-kind CMC expertise through two MAb manufacturing experts with considerable industry experience on our team. Please let us know if this would be useful to you. We appreciate your frontline efforts to address this problem and look forward to helping where we might. Warm regards, Trevor <image001.png> Trevor Mundel, MD, PhD President, Global Health Program v F E gatesfoundation.org Amissa Cormier Senior Program Assistant Global Health Office of the President Vv M E gatesfoundation.org Bill & Melinda Gates Foundation www.gatesfoundation.org