Do more before Ebola reaches tipping point
This is my Arab News column published on October 12, 2014:
By Rasheed Abou-Alsamh
Watching a BBC report this week on a desperate family in Liberia that had a male member ill with the Ebola virus, driving from one emergency medical center to another, only to be turned away from them all, was heart-wrenching.
They were confused and in the tropical heat looked dazed and angry, a woman frantically fanning the sick man who looked too weak and feverish to walk, let alone stand up, as he sat slumped in the front passenger seat. The reporter bravely gave the family rubber gloves to use, the most she could do in such extreme conditions, where in a tiny and impoverished nation such as Liberia, this deadly virus has completely overwhelmed the public health system. The sick man died shortly thereafter.
With more than 4,000 deaths now from the Ebola virus, and more than 8,000 people in West Africa infected with it, according to the World Health Organization, we have an epidemic on our hands. And if more is not done quickly, such as more experimental drugs to treat Ebola victims, and vaccines invented to prevent infection, then we will soon have a global pandemic. For sure the Ebola virus is not that easily transmitted, but it is also not that difficult to become contaminated with it if you come into contact with the bodily fluids of infected patients, as we have seen with the various nurses and aid workers, who have come down with the disease. And the mortality rates are extremely high: 70 percent of Ebola patients in West Africa are dying from it, Robert Murphy, a professor of medicine at Northwestern University in Chicago, told USA Today.
Which brings us to how the disease is being fought, how patients are being treated or not, and why finding a cure still doesn’t seem to be a high priority for major pharmaceutical companies. The first three Americans exposed to the virus in West Africa were all flown home to the United States where they received the best medical treatment in the world, including the experimental drugs ZMapp and TKM-Ebola. They also received blood transfusions from Ebola survivors, in the hope that their antibodies would strengthen their immune system against the virus. All three survived and have recovered well.
Compare their treatment to that of the 42-year-old Liberian Thomas Eric Duncan who just died this week of the Ebola virus in a Dallas hospital. He was not offered ZMapp or TKM-Ebola. According to the Atlanta Blackstar news site, contradictory reasons were given for why Duncan did not get the drugs. Tom Frieden, the director of the Centers for Disease Control and Prevention, said that doctors treating Duncan feared the drug might worsen his condition. Dr. Anthony Fauci of the National Institutes of Health claimed that supplies of ZMapp were exhausted, and that it would take six to eight weeks before new supplies would be ready. Duncan was given brincidofovir, an experimental antiviral drug, more than one week after he was admitted to hospital, according to USA Today. Obviously, that was not enough to save his life. He was not offered blood transfusions or any other experimental drugs according to the paper.
The good news, if you can even call it that, is that the WHO has fast-tracked the development of experimental vaccines against Ebola, agreeing to skip the usual randomized controlled tests in which some participants get the vaccine and others a placebo. The WHO said that it was ethical to give Ebola patients untested vaccines, although the risks and benefits should be strictly evaluated and the results shared. Several experimental vaccines are being tested in Africa, and hopefully will be able to save lives once they are produced and used on larger scales.
The US government has already sent 400 US military personnel to Liberia to set-up blood screening centers that process blood samples from Ebola patients. The US House of Representatives has now approved a further $700 million in funding to deploy a further 4,000 American troops to West Africa to help in the fight against Ebola. Cuba too has sent 165 doctors to Sierra Leone and will send a further 296 doctors to Liberia and Guinea.
Big pharmaceutical companies are not beating down anyone’s door to develop Ebola vaccines or treatment drugs because so far the majority of the victims have been poor Africans, who could never afford to buy expensive medicines that these manufacturers would want to push them to do in order to recoup their research and development costs in bringing these Ebola drugs quickly to the market. But this is a global emergency and all governments involved — African, Western, and Asian — should get together and pool their resources to fast-track the development of an Ebola vaccine. They could do so by using government laboratories or in some sort of government-private sector partnership where they offered private pharmaceutical firms tax incentives to develop these drugs quickly and cheaply.
All of our lives are in danger if not enough is done now, and Ebola is allowed to become to a global scourge. We cannot continue to be complacent, as our future depends on it.