{"id":20963,"date":"2014-08-07T16:45:56","date_gmt":"2014-08-07T08:45:56","guid":{"rendered":"https:\/\/canadianinquirer.net\/v1\/?p=20963"},"modified":"2025-01-13T05:35:01","modified_gmt":"2025-01-13T10:35:01","slug":"debate-over-whos-first-in-line-for-experimental-ebola-drug-even-though-little-is-available","status":"publish","type":"post","link":"https:\/\/canadianinquirer.net\/v1\/2014\/08\/07\/debate-over-whos-first-in-line-for-experimental-ebola-drug-even-though-little-is-available\/","title":{"rendered":"Debate over who\u2019s first in line for experimental Ebola drug even though little is available"},"content":{"rendered":"

\"shutterstock_206919739\"<\/a><\/p>\n

WASHINGTON\u2014The use of an experimental drug to treat two Americans diagnosed with Ebola is raising ethical questions about who gets first access to unproven new therapies for the deadly disease. But some health experts fear debate over extremely limited doses will distract from tried-and-true measures to curb the growing outbreak\u2014things like more rapidly identifying and isolating the sick.<\/p>\n

The World Health Organization is convening a meeting of medical ethicists next week to examine what it calls \u201cthe responsible thing to do\u201d about whatever supplies eventually may become available of a medicine that\u2019s never been tested in people.<\/p>\n

At least one country involved in the outbreak is interested in the drug. Nigeria\u2019s health minister, Onyenbuchi Chukwu, said at a news conference that he had asked the U.S. Centers for Disease Control and Prevention about access. CDC Director Tom Frieden \u201cconveyed there are virtually no doses available\u201d but that basic supportive care can work, a CDC spokesman said Wednesday.<\/p>\n

President Barack Obama said Ebola is controllable and the U.S. and its allies are working to help overwhelmed public health systems in West Africa take the needed steps.<\/p>\n

Asked about the experimental drug, Obama said all the information isn\u2019t in: \u201cWe\u2019ve got to let the science guide us.\u201d<\/p>\n

There is no proven treatment or vaccine for Ebola, which so far has infected more than 1,700 people and killed more than 930 in West Africa in what has become the worst outbreak of this viral hemorrhagic fever.<\/p>\n

\u201cHow many times have we found magic therapies that ended up … doing more harm than good?\u201d cautioned University of Minnesota professor Michael Osterholm, who advises the U.<\/p>\n

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S. government on infectious disease threats.<\/p>\n

\u201cVaccine and drug treatment right now is not going to be the main way you bring this to a stop,\u201d he added.<\/p>\n

Scientists stress that there\u2019s no way to tell if the experimental drug ZMapp really made a difference for two American aid workers infected while working in Liberia.<\/p>\n

\u201cWe don\u2019t even know if it works,\u201d stressed Dr. Anthony Fauci of the National Institutes of Health, which helped fund research that led to the drug\u2019s development.<\/p>\n

The drug is a cocktail of three antibodies engineered to recognize Ebola and bind to infected cells so that the immune system can kill them. People\u2019s immune systems make antibodies to fight off various diseases, and attempts to cull those antibodies\u2014from the blood of people who survive an illness, or from animals\u2014date back to the 19th century and early diphtheria treatment. Using modern techniques to fight Ebola, scientists culled antibodies from laboratory mice, Fauci said, and ZMapp\u2019s maker now grows the antibodies in tobacco plants and then purifies them.<\/p>\n

Fauci said the manufacturer has told the government that it would take two to three months to produce even \u201ca modest amount.\u201d So the NIH is exploring ways to ramp up production, necessary to attempt formal testing or to consider more so-called compassionate use.<\/p>\n

\u201cEverybody\u2019s trying to speed things up,\u201d said Fauci, director of NIH\u2019s National Institute of Allergy and Infectious Diseases.<\/p>\n

To help improve diagnosis in affected countries, the Food and Drug Administration on Wednesday authorized emergency use of an experimental blood test to detect Ebola. Early symptoms\u2014fever, vomiting and diarrhea\u2014can be confused with other illnesses. The test was developed by the Defence Department, and is only for use in DOD-designated laboratories.<\/p>\n

This week, the WHO is convening an emergency committee to determine if the outbreak warrants being declared a \u201cpublic health emergency of international concern,\u201d meaning it poses significant risk to other countries and requires more of an international response.<\/p>\n

The WHO said that particularly in Liberia, health officials face community resistance from residents who fear going to the hospital and secretly care for ill loved ones at home, thus exposing themselves. Ebola is transmitted only through direct contact with the blood and other bodily fluids of someone who is sick.<\/p>\n

But health care workers have to recognize the virus, too. Authorities in Nigeria have acknowledged that they didn\u2019t immediately suspect Ebola in the first known patient to travel to that country.<\/p>\n

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<\/p>\n

\u201cThe bottom line with Ebola is we know how to stop it: traditional public health,\u201d said CDC\u2019s Frieden said Wednesday: Finding and isolating patients, finding and educating who\u2019s been in contact with them and strict hospital infection control.<\/p>\n

\u201cDo those things with meticulous care and Ebola goes away,\u201d he said.<\/p>\n

Minnesota\u2019s Osterholm fears those tried-and-true methods could be overshadowed by misunderstanding about any availability of the experimental drug.<\/p>\n

\u201cIf the Americans had this serum all the time, why didn\u2019t they send it to us Africans to help save lives?\u201d said Winston Ojukutu Macauley, a social commentator in Sierra Leone.<\/p>\n

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<\/p>\n

But taking an experimental drug requires making sure the patients fully understand there\u2019s no proof it will help\u2014and it might even harm, said Osterholm, noting that 40 per cent of Ebola patients are surviving. And would it be appropriate for the U.S. to offer a drug to people in developing countries that hasn\u2019t been tested on its own citizens?<\/p>\n

That\u2019s among the things the WHO meeting could address. Even if enough doses were available for wider experimental use, \u201cwe need to find a way to do this in a fair manner so that we can live with ourselves when someone asks why this person got it and why not that person?\u201d said Dr. Heinz Feldmann, NIAID\u2019s virology chief.<\/p>\n

AP Medical Writers Maria Cheng reported from London and Mike Stobbe from New York. Associated Press writers Clarence Roy-Macaulay in Freetown, Sierra Leone, and Bashir Adigun in Abuja, Nigeria, contributed to this report.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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