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A WHO panel of ethicists was recently convened to discuss the outbreak of the Ebola virus in West Africa and to consider the possibility of providing untested interventions to battle this viral disease. The panel concluded that it was ethical to offer unproven interventions as potential treatments or for prevention of the deadly disease cause by the Ebola virus.
A statement was issued on August 12, 2014, after months of Ebola cases being announced in West Africa. The death toll from Ebola has reached 1,000 and fear is increasing that the Ebola virus may spread to many other places. The Ebola epidemic has already spread through Guinea, Sierra Leone, Nigeria and Liberia.
Infection with the Ebola virus causes tormenting problems that appear relatively quickly. The Ebola virus causes internal and external bleeding, a high fever, diarrhea and vomiting as multiple organ systems are affected. The Ebola virus is not spread through the air, like with the flu, but is transmitted through contact with bodily fluids or body organs. Blood, saliva and urine are bodily fluids that commonly transmit the virus from one person to another. It has been reported that Ebola has a 90 percent fatality rate.
An experimental drug for Ebola has only been used on a few cases so far. Two American missionaries contracted the Ebola virus while working in West Africa and they were sent back to the United States to be treated. These two Americans were the first to receive an experimental serum for Ebola. The experimental drug was also sent to treat a priest from Spain. The two Americans are still alive and so this experimental drug may have worked in their cases, however, the priest from Spain has died. The recent declaration by WHO that experimental drugs can ethically be used on people with Ebola means that use of these drugs will begin on the numerous cases of Ebola in West Africa.
ZMapp is the name of one of the serums that has been developed to combat Ebola. ZMapp was developed by Mapp Biopharmaceutical Inc., which is a San Diego biotech firm. Plans already exist for this drug to be sent to Liberia to treat doctors who have contracted Ebola. Mapp Biopharmaceutical Inc. will be ramping up production of ZMapp for more widespread use in West Africa. It has been reported that several other experimental drugs and vaccines are being developed for Ebola. A drug called TKM-Ebola, developed by Tekmira Pharmaceuticals, is in the pipeline for testing and use.
The WHO will convene another panel at the end of August to discuss priorities for access to experimental drugs designed to treat Ebola. The original WHO statement advised that, if and when experimental drugs are used to treat patients with Ebola, there is a moral obligation to share the data that results. It was agreed that there is also a moral duty to evaluate the interventions in clinical trials under the circumstances to assess safety and efficacy.
By Margaret Lutze