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Who gets experimental Ebola drug?
August 7, 2014, 8:36 pm
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The 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 — things like more rapidly identifying and isolating the sick.

At least one country involved in the outbreak is interested in the drug. Nigeria’s health minister, Onyenbuchi Chukwu, said that he had asked the US Centers for Disease Control and Prevention about access. CDC Director Tom Frieden “conveyed there are virtually no doses available” but basic supportive care can work, a CDC spokesman said on Wednesday.

“How many times have we found magic therapies that ended up ... doing more harm than good?” cautioned University of Minnesota professor Michael Osterholm, who advises the US government on infectious disease threats. “Vaccine and drug treatment right now is not going to be the main way you bring this to a stop,” he added.

Scientists stress that there’s no way to tell if the experimental drug ZMapp really made a difference for the two American aid workers. “We don’t even know if it works,” said Dr. Anthony Fauci of the National Institutes of Health, which helped fund research that led to the drug’s development.

Fauci said the manufacturer has told the government that it would take two to three months to produce even “a modest amount.” “Everybody’s trying to speed things up,” he said. Osterholm fears tried-and-true methods could be overshadowed by misunderstanding about any availability of the experimental drug.

“If the Americans had this serum all the time, why didn’t they send it to us Africans to help save lives?” said Winston Ojukutu Macauley, a social commentator in Sierra Leone.

But taking an experimental drug requires making sure the patients fully understand there’s no proof it will help — and it might even harm, said Osterholm, noting that 40 percent of Ebola patients are surviving. And would it be appropriate for the US to offer a drug to people in developing countries that hasn’t been tested on its own citizens?

That’s among the things the WHO meeting could address in a meeting on Friday. Even if enough doses were available for wider experimental use, “we 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?” said Dr. Heinz Feldmann, NIAID’s virology chief.

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