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Ebola politics

8/7/2014

Ebola. Even the word by itself conjures up horrible disease, unpleasant symptoms, even death. Which is why it's making the news so prominently.

Ebola. Even the word by itself conjures up horrible disease, unpleasant symptoms, even death. Which is why it's making the news so prominently.

That statement actually needs amending. The virus has been killing hundreds of West Africans but it took American health workers to be infected before it became fodder for the U.S. news cycle. That isn't an indictment of journalistic news judgment; simply part of it. The closer to home something hits, the bigger its news value.

But there is an ethical aspect of the American version of the Ebola story that troubles us greatly. It is well-documented the virus, which presents itself with flu-like symptoms that can progress to kidney or liver failure, leads to death in many cases. The death rate is approximately 60 percent as there is no cure or treatment for the virus.

Or at least that is the official story. And it is borne out by the 1,711 people in Sierra Leone, Libera, Nigeria and Guinea that have been diagnosed with Ebola. No fewer than 932 of the West Africans have died.

The World Health Organization was having a special summit of international experts in Geneva to determine if the outbreak constitutes a "public health emergency of international concern." Next week the WHO will convene medical ethicists to explore using experimental drugs and treatments that have not been approved. The Centers for Disease Control and Prevention has its Atlanta facility on the highest response level. The CDC also sent an additional 50 disease control specialists to Africa to assist. And the FDA has given fast-track approval status to multiple vaccines under development to prevent Ebola, although these couldn't help people already infected.

And then there is the case of Dr. Kent Brantly and Nancy Writebol, two American missionaries who were in Liberia to treat Ebola patients. They themselves became infected and were offered an unapproved experimental serum, which improved their conditions enough to transport them back to the States for further treatment.

The serum, a drug called ZMapp, had previously been tested only on monkeys -- although those tests showed great promise.

As the two Americans recover and Africans continue dying, an ethical and moral debate has begun raging.

"It is highly likely that if Ebola were now spreading in Western countries, public-health authorities would give at-risk patients access to experimental drugs or vaccines," three public health experts said in a statement posted on the Wellcome Trust website Wednesday. "The African countries where the current outbreaks of Ebola are occurring should have the same opportunity. African governments should be allowed to make informed decisions about whether or not to use these products, for example to protect and treat health-care workers who run especially high risks of infection."

One of the experts was Peter Piot, director of the London School of Hygiene and Tropical Medicine and a co-discoverer of the Ebola virus.

Others, such as the group Doctors Without Borders, offered: "Trying an untested drug on patients is a very difficult choice since our first priority is to do no harm and we would not be sure that the experimental treatment would do more harm than good."

And the WHO has dismissed the idea of offering the drug to Africa. The organization "would not recommend any drug that has not gone through the normal process of licensing and clinical trials," as Reuters reported.

We won't pretend to be experts in medical ethics. Yet the fact ZMapp serum's use is out in the open alters the equation. It is bad enough so many African people are dying from the virus; to make public even the potentially successful treatment of U.S. citizens who were in Africa at the time presents a different dynamic. The conflict arising in West Africa about who should receive experimental drugs could grow larger than the Ebola crisis itself.

As most of the infected patients will die from Ebola, they truly have nothing to lose. Part of the international response should be to allow the experimental drugs to be tested in a real-live setting. To not allow this truly is immoral.

The potentially hero serum already has been introduced in West Africa. It just hasn't been made available to West Africans. That needs to change.

Editorial by Patrick Lowry

plowry@dailynews.net

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