Ebola has lurked around African tropical rainforests for decades and can have a fatality rate up to 90 percent. But despite Ebola's deadly record, it remains a disease without a proven drug for economic reasons.
People sporting puffy, space-like suits. Depressurized, airlocked rooms. A big sign with the word "Stop" in bold letters.
This is the isolation ward of University Medical Center Hamburg-Eppendorf and the scene that greeted the Senegalese health worker, the first Ebola patient to be treated in Germany, when he was wheeled into the hospital on August 27, 2014.
Ebola is nothing new in this German town. In 2009, a German scientist working at the Bernhard Nocht Institute for Tropical Medicine, a Hamburg research lab specializing in infectious diseases, was given the first dose of an experimental Ebola vaccine, after she accidentally pricked herself with a needle.
But that was five years ago, and there still is no Ebola vaccine on the market to combat the current Ebola epidemic - the largest in history in terms of deaths - even though some researchers think the science is advanced enough to make an effective vaccine.
The story of Ebola is one of the starkest health challenges now facing public health officials, but one that perhaps could have been avoided. It's a story of how economics trumped public health, how infection rates were reduced to probabilities, how urgency took on a new meaning when the first-world was affected.
Unprofitable and unpopular disease
"In the end, it all comes down to money," said Matthias Schnell, Ebola researcher at Thomas Jefferson University in Philadelphia.
Stuttgart-educated Schnell told DW he has faced challenges finding investment for his vaccine, which would protect against both Ebola and rabies. Only the US National Institutes of Health (NIH) had provided funding for his pre-clinical drug.
Larger companies have shied away from taking his vaccine to the next phase - human clinical trials, he said.
"It would be great if a big commercial company got involved to produce this vaccine," Schnell said, "but big pharma is only interested in making millions in profit."
Like Schnell's drug, the few Ebola vaccines in the pipeline have mostly been funded by national governments and smaller biomedical firms up to now.
Entry of a healthcare major
But a British healthcare giant has recently gotten involved, causing a buzz in the public health community.
The world's sixth-largest pharmaceutical company, GlaxoSmithKline (GSK) is now working with the NIH to begin testing an Ebola vaccine in humans, expected to begin as early as mid-September, the company announced August 28, 2014. These safety trials are expected to last until the end of the year.
GSK had acquired an Ebola vaccine last year after buying Swiss-based biotech company Okairos for 250 million euros ($329 million). In response to the Ebola epidemic, the Brentford-based company said human trials of the vaccine will be accelerated with funds from an international consortium, comprised of foundation and UK government money.
The consortium's funding will also enable the multinational to begin manufacturing up to around 10,000 additional doses of the vaccine at the same time as the initial clinical trials, GSK said in a written statement.
GSK did not get in touch with DW, despite multiple requests for an interview. The company also canceled its August 28 telephone briefing for journalists at the last minute.
Alongside this drug by GSK, another experimental Ebola vaccine is also set to enter human clinical trials in the fall - NIH reportone developed by the Public Health Agency of Canada and licensed to NewLink Genetics#.
The WHO has pledged its commitment to supporting scientific research in Ebola vaccines. The organization does not specifically raise money for vaccine production, but it is supporting efforts to fast-track development.
This is possible through discussions with regulators and scientists, the UN agency said. WHO tries to bring together major players in the research, regulatory and clinical worlds and get them to agree on next steps, so that they are all on the same page, WHO spokesperson Dr. Margaret Harris told DW.
"Ebola is now an extraordinary event and has spread to more than one country," Harris said. "That makes it an international concern."
WHO also works with Gavi Alliance, a public-private global health partnership based in Geneva, to help increase access to vaccines in developing countries.
Gavi spokesperson Melissa Malhame said there has been little financial incentive for manufacturers to develop and produce new products for developing countries.
"If there is a disease existing in 10 countries in Africa, and that's the full extent of the market that's there, then the incentive to develop the vaccine is different for a company because of the revenue it gets for it," Malhame said.
In other words, there's no large, constant demand, meaning a poor return on investment for the pharmaceutical industry, which can spend a decade and $1 billion on every drug it brings to market.
Only 30 million euros
Although Gavi tries hard to incentivize manufacturers, researchers for less-common diseases, like Thomas Jefferson University's Matthias Schnell, still struggle to get a pharmaceutical giant to invest in their work.
Schnell said if he only had about 30 million euros, he would have the necessary funds to bring an Ebola vaccine to market.
"It's relatively simple to do it," Schnell said, "but you just need some money."
Ebola has already claimed over 1,550 lives in four countries, according to the WHO. The organization said cases could eventually exceed 20,000 - in which one out of two people infected with the disease would die.