Lassa fever remains one of the most pressing public health threats in West Africa. According to the Africa CDC, the viral haemorrhagic fever (VHF) infects between 100,000 and 300,000 people annually, with thousands of deaths recorded across the region. Nigeria and neighbouring countries bear the brunt of recurring outbreaks, with significant challenges in diagnostics, treatment, vaccine development, and community acceptance.
Building on the inaugural Lassa Fever Conference in Abuja in 2019, which brought the disease to greater global prominence, the ECOWAS Lassa Fever International Conference under the theme Beyond Borders: Strengthening Regional Cooperation to Combat Lassa Fever and Emerging Infectious Diseases was convened in Abidjan, Cote d’Ivoire. This year’s meeting placed stronger emphasis on countries in West Africa that are endemic for Lassa fever. Ministers of Health and health advocates from across the region gathered for high level discussions on Lassa Fever, sharing technical and scientific insights.
The conference brought together experts and leaders across research, regulation, product development, and clinical trials to highlight barriers and recommend actionable steps to strengthen the region’s commitment to ending Lassa fever as a public health threat.
Harmonising and streamlining processes
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Discussions at the conference spanned a wide range of issues shaping Lassa fever preparedness and response. The included leveraging digital innovation for research, advancing vaccine development and access, and applying behavioural and social science. The plenary session “Closing the Gap: Accelerating VHFs’ medical countermeasure R&D in West Africa”, highlighted recent progress in vaccine development, therapeutics, and diagnostics, while making clear the pivotal role of locally led clinical trial platforms in strengthening regional capacity.
Dr. Ifedayo Adetifa, Chief Transformation Officer/CEO at FIND emphasised the urgent need to harmonise and streamline regulatory processes to facilitate research and product development (R&D). He pointed out that a major gap in accelerating viral haemorrhagic fever (VHF) medical countermeasures R &D in West Africa is the lack of clinical validation networks, which require both specialised expertise and well-maintained biobanks of specimens. According to him quality-assured and validated biobank specimens form the foundation for discovery and development. Dr Adetifa stressed that “Lassa fever is a regional and local problem and if we look at the African perspective it’s a national problem and we cannot expect solutions to come from outside the region.” There is need to for domestic investment and concrete support for regional diagnostics.
Challenges in clinical research during outbreaks
Some countries have made progress in strengthening clinical research and clinical management for viral haemorrhagic fever such as Ebola, or Lassa fever. However key barriers remain, including limited access to drugs for treatment and investigational studies.
‘The pipeline for new drugs for Lassa is small and needs more improvement.” Explained Dr Mark Flenberg. He noted that contracting and negotiating with firms and countries to secure drugs for trials takes considerable time and effort. He also flagged socio-cultural barriers and stigma, which can make communities reluctant to accept clinical trials. In addition, ethnic conflict and insecurity may further complicate these efforts, reinforcing the need for sustained community engagement to ensure patients receive appropriate care while clinical trials are integrated effectively.
Vaccine development and the Lassa pipeline
The Coalition for Epidemic Preparedness Innovations CEPI, a research and development organisation focused on reducing global epidemic and pandemic risk, has made significant progress on the Lassa fever vaccine pipeline. Dr. Katrin Ramsauer, Lead, Lassa Fever Disease Programme at CEPI, explained that the seasonal nature of the disease and the limited number of high-incidence populations making large-scale trials difficult. Recruiting participants is also slow , and preparation goes beyond infrastructure, it requires skilled human resources, researchers, organisational support, strong local leadership, and regulatory capacity. She stressed the importance of working with regulators and exploring emergency use authorisation to address these barriers.
The Africa Medicines Agency has stepped forward to provide coordination. Dr. Ramsauer outlined key actions:
- engage regulators and generate evidence through greater investment in research.
- prepare for high-transmission seasons with ready-to-implement clinical trial protocols.
- identify immunological markers to better understand the disease.
- strengthen country and regional leadership, co-funding, and stakeholder support.
Building partnerships and regional capacity
Dr. Mark Feinberg, President and CEO of IAVI, emphasised the importance of a sustainable, partnership-driven model for product development. He stressed to need the need to Invest upfront, with resources mobilised from the start and development undertaken in-house. For Lassa fever, he noted the absence of commercial incentive reflects a clear market failure, making it necessary to adopt a different model. Drawing on IAVI’s two decades of experience in Africa, Feinburg highlighted the science of partnerships, where HIV, and TB vaccine trials have demonstrated the strength of African scientists taking leadership roles. He stressed that genuine and equal partnerships grounded in ownership, and long-term commitments are critical to success.
Improving preparedness and standard of care
In 2018, the World Health Organization WHO prioritised Lassa fever as a disease in urgent need of countermeasures. Since then, attention has focused on optimising standards of care to enable clinical trials. This includes ensuring reliable supply chains, strong health systems, effective patient referral pathways, early diagnostics and robust biosecurity measures, all of which create the foundation for clinical research. WHO has established a core protocol for trials, but the adoption of operational research requires approval from legal, ethics, and regulatory bodies, with governments taking the lead in implementation. Persistent knowledge gaps remain in clinical characterisation of Lassa fever, particularly complications in pregnant women and cases of organ failure. Addressing these gaps will require urgent investment in critical care preparedness, including intensive care capacity and oxygen supply.
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Building lasting solutions
The ECOWAS Lassa Fever International Conference highlighted both progress and persistent gaps in accelerating medical countermeasures against Viral Haemorrhagic Fevers (VHFs), with a particular focus on Lassa fever. Across diagnostics, drugs, vaccines, and trials, speakers emphasised the need for domestic investment, harmonised regulation, strong partnerships, and local ownership. While existing tools such as polymerase chain reaction PCR tests are available, affordability remains a challenge in several West African countries.
The overarching message was clear, addressing Lassa fever requires sustained investment, collaboration, and community trust. West Africa must take the lead with ownership, while global partners align to support lasting solutions. By uniting scientific innovation with political will and community trust, Lassa fever can be contained and future outbreaks prevented.