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Research and Ebola

By Zude Zyambo posted 08-07-2014 07:55 AM

  
The Ebola outbreak in West Africa was first reported in February this year and it has claimed many lives- and has created panic and anguish among the affected communities. As the disease has a very high mortality rate of 90%, is very contagious and has no known cure, doesn't this premise allow for use of an experimental drug under a research trial for the infected patients in West Africa? Then again, doesn't the treatment of only to US aid workers in the USA with a trial drug violate the principles of Justice( equitable recruitment of research participants and distribution of risk and benefits) and Beneficence( benefits for communities where the research is conducted) as the affected communities are in West Africa?
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Elizabeth Oseid
10-19-2014 10:54 AM

I can think of a few good reasons why this may be the case.
Limited quantities of experimental drug make it less available, assuming there is such a drug.
Desire to have testing done in a more controlled environment where drug related SAEs can be better managed.
Results may be more meaningful, easier to interpret. One can more easily rule out, for example, any role of malnutrition or dehydration, parasite burden, etc, etc, etc by doing trials in a developed country. It is frustrating, but I feel that in order to truly evaluate, one must begin in the controlled environment.
Although my background is in academia, and not related to infectious disease research, so I am hardly an expert in this area, I would be surprised if there are any drugs under development expressly for treatment of Ebola or any filovirus, for that matter. Such research is costly and requires specialized laboratories and training. This adds to the difficulties.I recently heard that they are trying to treat with serum from the recovered Doctor. That does not speak to having treatments to send to Africa, that sounds more like hopeful desperation.
The market is small and the desire would be for preventative treatments, such as vaccines. The high rate of mortality makes treatment after the fact ineffective for the most part. Hopefully that will change, and perhaps something can be isolated from the blood of the doctor that can give a vital clue. In the meantime, prevention is best. From the outset, a coordinated effort to contain the outbreak would have prevented much physical suffering and economic hardship. It is a shame that more was not done back in March or April along those lines. Wait and see is not appropriate in the case of BSL 4 organisms. Perhaps the world mechanism for addressing serious crises such as this need to be revisited to ensure that bureaucracy or false hope does not guide future decisionmaking. We are one world, and this affects us all.