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20 T M C ยป P U L S E | J U LY 2 0 1 8 So researchers used a different technique. The rVSV-ZEBOV vaccine works by placing part of the Ebola virus within a benign virus that isn't dangerous to humans. The Ebola vaccine essentially teaches the body's T-cells, a key part of the immune system, to recognize and attack Ebola, preventing the virus from replicating. Basically, the body trains on a fake version of the virus so it's better prepared when it encounters the real thing. Though the vaccine was promising, not much happened for a decade. Administering the vaccine faced a major logistical challenge because it's difficult to predict where the virus will strike. Meanwhile, testing the vaccine had been ethically fraught. And, there's the reality of the economics: Ebola was a relatively rare disease that only emerged every few years and While in the Army, Geisbert worked with Heinz Feldmann, M.D., Ph.D., then-chief of the special pathogens program at the Public Health Agency of Canada's National Microbiology Laboratory, on what ultimately would become an Ebola vaccine. Both scientists were part of a multi-national team of 14 researchers, including Geisbert's wife, virologist Joan Geisbert, from the United States, Canada, Germany and France who published the sem- inal 2005 paper in Nature Medicine unveiling their Ebola vaccine that worked in non-human primates. Traditionally, vaccines for condi- tions like the flu or meningitis work by prompting the body to generate disease-fighting antibodies. But when that same technique has been used with Ebola, the resulting antibodies have been ineffective at controlling the disease. there wasn't a lot of money to be made from vaccinations. "So we had these vaccines in the 2000s, and we knew they worked great in monkeys, but they just sat there, honestly," Geisbert said. It's a problem that's not unique to Ebola, said Peter Hotez, M.D., Ph.D., dean for the National School of Tropical Medicine at Baylor College of Medicine. Ebola was considered a "neglected disease," Hotez said, and was viewed as a low priority. Then came the Ebola outbreak in West Africa from 2014 to 2016, which killed more than 11,000 peo- ple. Cases also arose in the United States. No longer could the disease be considered a terrifying condition that had relatively limited impact. For the first time, Ebola killed on a massive scale. "It changed the way we thought about Ebola," Geisbert said. Motorcycle and bicycle taxis wait for passengers outside Wangata hospital in the town of Mbandaka, Congo, where hundreds were vaccinated against Congo's deadly Ebola outbreak in late May.