Opinion: The ethics of Ebola experimentation

Is it right that safety testing should be set aside in the race to find a treatment for Ebola?

Hilary Ayshford
Managing Editor

After bird flu and SARS the world now lives in dread of Ebola, with a fatality rate of up to 90% and no vaccine or cure.

The WHO has declared the Ebola outbreak a global health emergency, and while this has focused attention on the need to speed up the development of promising treatments and vaccines and to improve emergency responses to such outbreaks, this will offer little immediate comfort to the African countries affected.

There are a number of drugs in the pipeline, only one of which – TKM-Ebola from Canadian company Tekmira – has been trialled in healthy volunteers, although the FDA has lifted safety restrictions, allowing it to be used on patients who are already infected with the Ebola virus.

The WHO has said that in light of the scale of the outbreak it is ethical to use untested drugs to treat infected patients as long as there is informed consent and the results of the treatment are collected and shared. The Liberian government has put in a request for ZMapp – an experimental drug from California-based Mapp Biopharmaceutical. Although the drug has not been tested for safety in humans, any risks must appear small compared with the high probability of death from the virus.

But supplies of experimental drugs are very limited. So who should be the priority – the sickest patients or those with the best chance of recovery? Or should they be reserved for the health workers at greatest risk while caring for the sick and dying?

The truth is that as dreadful a disease as Ebola is, with the number of deaths in the low thousands it ranks well below some of the other conditions that threaten large parts of the world and kill many more people each year, such as malaria, Dengue Fever, rabies, pneumonia, rotavirus and measles.

While public attention is focused on Ebola, this could be a good time to stress the value of vaccinating against preventable diseases and to highlight the serious threat of antibiotic resistance in the hope that the world might finally sit up and take notice.

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