A Cure For Ebola? Ctd

by Dish Staff

Yesterday the World Health Organization determined that it is “ethically sound” to administer promising but unproven Ebola treatments on a wide scale, countering earlier criticism that one such treatment, the experimental antibody therapy ZMapp, had been made available exclusively to Westerners. The Liberian government has announced that it will be administering the drug to two afflicted doctors in the country, but as Josh Lowensohn notes, it remains unclear just how much medicine will ultimately make it to West Africa:

Supplies of the drug have also dwindled due to difficulties producing it, though Canada today said it would donate 800 to 1,000 doses of the drug to be used in aid efforts. A separate drug called TKM-Ebola, which is also developed in Canada, could end up being used as well after getting a nod from the US Food and Drug Administration last week to restart human testing of the drug on those who are already infected.

Peter Loftus notes ominously, “The maker of the experimental Ebola drug that was given to two infected Americans said Monday that its supply has been exhausted after the company provided doses to a West African nation [presumably Liberia]“:

Mapp Biopharmaceutical Inc. said in a brief online statement it had complied with every request for the drug that had the necessary legal and regulatory authorization. The company said it provided the drug, called ZMapp, at no cost in all cases. San Diego-based Mapp didn’t name any countries that requested the drug and didn’t release additional details.

Alexandra Sifferlin considers how health officials will make the tough decisions about administering the drugs:

[N]ow the question is: With not enough to go around, who gets them? That’s ultimately at the discretion of the countries themselves, and before that happens, there’s a waiting period as the WHO formulates another panel of technical experts to create guidelines for the best use of these drugs. Some of the questions they will try to answer are: At what stage of the disease are the drugs or vaccines effective? Are they effective at the beginning of the disease or at the later stages? What are the safety issues related to the drugs? What’s the efficacy of the drug—do 30 percent of people respond or 50 percent?

“It think [who gets the drugs] is one of the most difficult questions to answer,” says Dr. Abha Saxena, the coordinator for the global ethics team at WHO. “There is a limited supply and there is a lot of demand. But who gets it is contextual, it will depend upon on the country, the situation, and they type of drug that will eventually go forward into either trial or compassionate use.” The panel will meet by the end of this month.

Meanwhile, Amanda Taub suggests that “most of the people Ebola kills may never actually contract it”:

New, worrying information from Sierra Leone suggests that damage from the disease may go far beyond deaths from the Ebola virus itself. Rather, Ebola is claiming more victims by damaging already-weak local health systems and their ability to respond to other medical problems, from malaria to emergency c-sections. The ebola-driven rise in deaths from those other maladies may outpace the deaths from ebola itself.

The effect of the loss of services may be severe. Even before the Ebola outbreak, Sierra Leone was ranked the seventh-worst country in the world for maternal and child mortality. In 2012, the aid group Save the Children reported that 18 percent of children in Sierra Leone did not survive to age 5, and one in 25 women died of childbirth or pregnancy-related causes. If these fears prove correct, those numbers may be about to get much worse.