WHO backs use of experimental Ebola drugs
KATE KELLAND AND STEPHANIE NEBEHAY
People infected in the West Africa Ebola outbreak can be offered untested drugs, the World Health Organisation (WHO) has revealed.
However, scarce supplies raise questions about who gets priority in the epidemic of the virus, which has no proven treatment.
Liberia said it planned to treat two infected doctors with an unproven Ebola medicine called ZMapp, the first Africans to receive the drug, while a Spanish priest, who the Health Ministry in Madrid said had also been given ZMapp, died.
The West Africa Ebola virus epidemic - the world's largest and deadliest so far - has killed at least 1,013 people in Guinea, Liberia, Sierra Leone and Nigeria. The WHO has declared it an international health emergency and predicts the epidemic will continue for months.
There are no licensed treatments or vaccines for Ebola, but several biotech companies and research teams have been working on potential drugs. Some in West Africa took to social media to express their lack of hope of being offered those treatments.
"There was unanimous agreement among the experts that in the special circumstances of this Ebola outbreak it is ethical to offer unregistered interventions as potential treatments or prevention," the WHO's assistant director general Marie-Paule Kieny said after an ethics panel published its guidance.
The WHO-convened panel of medical ethicists said several potential drugs had passed the laboratory and animal study phases of development, and should now be fast-tracked into clinical trials as well as being made available for compassionate use.
"If these treatments can save lives - as the animal studies suggest - should we not use them to save lives, as far too many lives are being lost right now?" Kieny said.
The WHO ethics meeting was called after experimental Ebola drug ZMapp, made by US biotech company Mapp Biopharmaceutical, was given to two American aid workers infected with Ebola in Liberia.
The two US aid workers have shown some signs of improvements since being given the drug, and Kieny said she had heard reports that the treatment had had a swift and dramatic effect in these patients.
Only around 10 to 12 doses had been made of the experimental drug, according to the WHO. Liberia was preparing to treat the two Liberian doctors with ZMapp after US authorities approved its export.
A 75-year-old priest in Spain, who the Health Ministry said was also being treated with ZMapp, died in hospital in Madrid on Tuesday. He contracted Ebola in Liberia while working for a non-governmental organisation.
Ben Neuman, a virologist at Britain's University of Reading, said the WHO panel's decision was welcome.
"The humanitarian case for treatment in a disease as deadly as Ebola is very clear cut. If I had Ebola, I would be looking for any treatment available, even if it was only at an experimental stage," he said.
The epidemic in West Africa, one of the world's poorest regions where crumbling healthcare systems are unable to cope, has also raised the issue of who should been given priority for any drug that might become available for compassionate use.
On Twitter, users in the region created the #GiveUsTheSerum hashtag to voice their frustration at the failure to provide experimental medicines to people on the continent.
The WHO's ethics panel said it was likely the first tests of these drugs in humans would be conducted over the next two to four months, but cautioned that even after that and if the trials proved successful, supplies would be limited.
"It is ... likely that the number of doses available for further study and/or deployment from end 2014 onwards will remain insufficient to meet demand," the statement said.
Companies with possible treatments include Tekmira Pharmaceuticals, Biocryst Pharmaceuticals and Siga Technologies.
GlaxoSmithKline and US scientists at the National Institute of Allergy and Infectious Diseases hope to start a clinical trial of an experimental Ebola vaccine as soon as next month, after promising test results in primates.
Another experimental vaccine from Johnson & Johnson's Crucell unit should enter Phase I clinical trials in late 2015 or early 2016, while Profectus Biosciences is also working with US scientists on another preclinical vaccine.
The WHO has said the epidemic will likely continue for months as the region's healthcare systems struggle to cope and has appealed urgently for funding and emergency medical staff.
Ivory Coast, the economic powerhouse of French-speaking West Africa, on Monday banned air travellers from the three countries worst-hit by the Ebola outbreak and ordered its flagship carrier Air Cote d'Ivoire to cease flights to and from them.
Ivory Coast has not registered any cases but is seen as vulnerable given its shared borders with Guinea and Liberia.
Rwanda's Health Ministry said the country's first suspected case of Ebola, a German medical student who had spent time in Liberia, had tested negative.