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WHO to convene panel on use of experimental Ebola drugs

The World Health Organization said Wednesday that it would convene a group of medical ethicists early next week to wrestle with questions about the use of experimental treatments in the deepening Ebola outbreak in West Africa.

Currently, no approved treatment or vaccine exists to treat the devastating disease, which kills 60 to 90 percent of patients who contract it. There are a handful of promising treatments under development, but none have been tested on humans.

The issue has gained widespread attention in recent days after two U.S. missionaries who were infected with Ebola while treating patients in Liberia received doses of an experimental serum known as ZMapp, which contains a cocktail of antibodies meant to fight off the disease.

The grave conditions of both Americans improved noticeably after they received ZMapp, according to reports, although it remains unclear how much of their progress was attributable to the drug.

Only a handful of doses of ZMapp exist, according to authorities, though the companies that produce it have said they are working with government agencies to ramp up production. Still it likely would take months to manufacture enough of the cocktail of antibodies to distribute widely in West Africa.

Many health centers in Liberia are closing, as medical personnel are refusing to come into work for fear of being infected with the Ebola virus. (Reuters)

A Cambridge, Mass., biotech firm is also urging federal authorities to allow its experimental drug to be used on people infected with the Ebola virus, according to the Boston Globe.  Sarepta Therapeutics says it could treat about two dozen patients within a week and could provide enough of its drug for another 100 patients within a few months, according to the newspaper.

Officials said Wednesday that the Nigerian government has asked the U.S. Centers for Disease Control and Prevention for access to the treatment that was given to missionaries Kent Brantly and Nancy Writebol.

The WHO acknowledged Wednesday that treatment of the two Americans has raised questions about whether medicine that has never been proven safe and effective in humans should be used during an outbreak of the magnitude of the one in West Africa. Typically, new drugs go through years of trials before being approved for wide distribution.

Even if the potential benefits far outweigh the risks, plenty of other questions remain. Given the limited quantities of many experimental drugs, how would authorities decide who receives it? Who would pay for it? Who is responsible if a drug does more harm than good?

“We are in an unusual situation in this outbreak,” Marie-Paule Kieny, WHO assistant director-general, said in a statement Wednesday. “We have a disease with a high fatality rate without any proven treatment or vaccine. We need to ask medical ethicists to give us guidance on what the responsible thing to do is.”

The WHO does not approve medicines and is not a regulatory agency. But it does set norms and standards, and often provides guidance when a public health emergency arises. Agency officials said Wednesday that the WHO plans to convene the group on Monday or Tuesday, with the hope of moving as quickly as possible given the urgent nature of the crisis in West Africa.

Also Wednesday, the Food and Drug Administration said it had issued an emergency authorization for the use of an in vitro diagnostic test developed by the Defense Department to help detect the strain of the Ebola virus ravaging West Africa. The test is designed for use in individuals, including medical personnel, who may have been exposed to the virus.

The WHO and FDA actions Wednesday underscored the urgency of the worsening situation in West Africa, where Ebola continues to spread in four countries — Liberia, Nigeria, Guinea and Sierra Leone. The WHO reported Wednesday that the death toll from the outbreak has risen to 932, with more than 1,711 total cases.

Read more:

Photos: West Africa struggles to contain outbreak

Two Americans with Ebola receive experimental serum

CDC disease detective: 'They didn’t believe this was Ebola'

Can we give that experimental Ebola drug to West African victims?

Brady Dennis is a national reporter for The Washington Post, focusing on food and drug issues.
Lenny Bernstein covers health and medicine. He started as an editor on the Post’s National Desk in 2000 and has worked in Metro and Sports.



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Lenny Bernstein and Brady Dennis · August 5, 2014

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