Experimental Ebola drug sparks ethical controversy

August 7, 2014 by Naomi Seck

The decision to use an experimental drug to treat two Americans infected with Ebola, while nearly 1,000 Africans have already died from the deadly epidemic, has sparked controversy—but US experts say it was ethically justified.

The World Health Organization announced Wednesday it was convening a special meeting next week to explore using experimental drugs in the West African outbreak, after two health workers from the US charity Samaritan's Purse were treated with a drug called ZMapp.

The is still in an extremely early phase of development and had only been tested previously on monkeys. It has never been produced on a large scale. There is no proven treatment or cure for Ebola.

Samaritan's Purse members Kent Brantly and Nancy Writebol, however, have shown improvements since taking the drug.

Why not in Africa?

The news has prompted calls to make the drug available to hard-hit Guinea, Liberia and Sierra Leone.

Nigeria, where there have been seven confirmed cases so far, has already announced talks with the US Centers for Disease Control on the possibility of getting access to ZMapp.

And three leading Ebola experts, including Peter Piot, who co-discovered the Ebola virus in 1976 and is director of the London School of Hygiene and Tropical Medicine, urged the drug be made more widely available.

"It is highly likely that if Ebola were now spreading in Western countries, authorities would give at-risk patients access to experimental drugs or vaccines," said the joint statement Wednesday, according to the Los Angeles Times.

"The African countries where the current outbreaks of Ebola are occurring should have the same opportunity," it added.

Mapp Pharmaceuticals, the US company behind the drug, said any decision to use the drug should be made by treating doctors within regulatory guidelines, and added it is working to increase production.

Risk the untested?

But US President Barack Obama said Wednesday afflicted countries should focus on proven public health measures, rather than an untested drug.

However, "I will continue to seek information about what we're learning with respect to these drugs going forward," he added.

Experts said extending the use of ZMapp is not cut and dry.

They also dismissed questions over the fairness of offering ZMapp first, and so far only, to the two white Americans who have been infected.

"When you have that high a fatality rate, the pressures might appear irresistable. but you do have to remember there is harm that can come from unproven treatments," said G. Kevin Donovan, director of Georgetown University center for bioethics.

He said Brantly and Writebol were good candidates for taking the risky drug, since their medical training would have helped them understand the extent of the danger.

Furthermore, he said, they were especially deserving because "these are people who deliberately put themselves in harms way."

Many of the dead have been African and doctors, also infected while caring for patients. Sierra Leone's top Ebola doctor, Omar Khan, died July 29.

But Arthur Kaplan, director of New York University's medical ethics division, said the key difference is that "the religious mission (the Americans) worked for took it on themselves to find the drug," he said.

"I think we do need a system to ration scarce drugs, but no international group has suggested anything," he said.

He further stressed that even though they have had a good response so far, it is "far, far" from proven that the drug is actually beneficial.

"The ethical plan to follow is to redouble efforts to stop the epidemic by prevention."

Nancy Kass, a Johns Hopkins professor who formerly worked on the WHO's ethics committee, stressed that "there is a reason why drugs have to be tested before we give them to people."

It's "very easy to paint it as if there's nothing to lose," she said, but "I think there is something to lose."

Beyond the risk of the drug being harmful, it can be harder to understand the effects of a outside the controlled parameters of a study protocol, she said.

Whether it's ultimately worth it, is "a decision that should be made by the top experts in the world," Kass said, something she hopes will happen next week at the WHO.

Explore further: WHO calls ethics meeting over experimental Ebola drug

Related Stories

WHO calls ethics meeting over experimental Ebola drug

August 6, 2014
The World Health Organization said on Wednesday it was convening an ethics meeting next week to explore the use of experimental treatment in the Ebola outbreak in West Africa.

Experimental Ebola drug is hard to make, expert says

August 5, 2014
An experimental drug given to two American patients with Ebola is made from tobacco leaves and is hard to produce on a large scale, a leading US doctor said Tuesday.

'Experimental serum' is offered to US Ebola patients

July 31, 2014
A US doctor stricken with Ebola in Liberia was offered an experimental serum but insisted that his colleague receive it instead, a Christian aid agency said Thursday.

US woman with Ebola arrives in Atlanta for treatment

August 5, 2014
An American woman infected with the dangerous Ebola virus arrived at a US military base in Atlanta, Georgia, on Tuesday and is headed for treatment at a specially equipped hospital.

Peace Corps withdraws from W. Africa over Ebola fears

July 31, 2014
The US Peace Corps announced Wednesday it was pulling hundreds of volunteers from Guinea, Liberia and Sierra Leone due to growing concerns over the spread of the deadly Ebola epidemic raging in West Africa.

US doctor in Africa tests positive for Ebola

July 27, 2014
(AP)—A U.S. doctor working with Ebola patients in Liberia has tested positive for the deadly virus, an aid organization said Saturday.

Recommended for you

Study ends debate over role of steroids in treating septic shock

January 19, 2018
The results from the largest ever study of septic shock could improve treatment for critically ill patients and save health systems worldwide hundreds of millions of dollars each year.

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

Zika virus damages placenta, which may explain malformed babies

January 18, 2018
Though the Zika virus is widely known for a recent outbreak that caused children to be born with microencephaly, or having a small head, and other malformations, scientists have struggled to explain how the virus affects ...

Certain flu virus mutations may compensate for fitness costs of other mutations

January 18, 2018
Seasonal flu viruses continually undergo mutations that help them evade the human immune system, but some of these mutations can reduce a virus's potency. According to new research published in PLOS Pathogens, certain mutations ...

Study reveals how MRSA infection compromises lymphatic function

January 17, 2018
Infections of the skin or other soft tissues with the hard-to-treat MRSA (methicillin-resistant Staphylococcus aureus) bacteria appear to permanently compromise the lymphatic system, which is crucial to immune system function. ...

Fresh approach to tuberculosis vaccine offers better protection

January 17, 2018
A unique platform that resulted in a promising HIV vaccine has also led to a new, highly effective vaccine against tuberculosis that is moving toward testing in humans.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.