Two doctors in Liberia will be the first Africans to receive an experimental treatment for Ebola that has been previously only been used on two Americans and a Spaniard, Liberian officials announced on Monday. The decision comes on the heels of a World Health Organization panel’s ruling that it’s ethical to use the untested drug in an attempt to contain the deadly Ebola outbreak, which has claimed more than 1,000 lives in several West African nations.
There’s no cure and no vaccine for the Ebola virus, which is currently killing about 60 percent of the people who become infected with it. But an experimental Ebola drug called ZMapp, manufactured by a U.S. biotech company but not yet approved by the government, has shown promise in treating animals infected with the virus.
ZMapp was quickly given to the three Europeans who became infected with the disease while abroad — sparking concerns about the disparities in treatment emerging along geographic, economic, and racial lines. Now, the U.S. government is helping connect Liberian officials with the drug maker to ship doses into the country, but it’s still unclear how much of the limited supply Liberia will receive.
The current Ebola crisis has brought up several ethical dilemmas for the international community. In addition to questions about who should receive a chance to try experimental drugs, there’s some disagreement about whether it’s appropriate to sanction untested treatments in the first place.
Last week, President Obama suggested that fast-tracking ZMapp for use in African patients would be “premature” since it’s still somewhat unclear whether the drug is effective or safe. “I don’t think all the information is in on whether this drug is helpful,” he said at a press conference on Thursday. “Let’s help to bolster the [health] systems that they already have in place [in Africa]. Let’s nip as early as possible any additional outbreaks of the disease.”
On Monday, the WHO panel determined that the risk is worth taking in an attempt to contain the spread of the virus, as long as they people receiving the untested treatment have freedom of choice and give their full consent. Liberian information minister Lewis Brown agrees. “Between choosing a risk and choosing dying, I am sure many would prefer to see that risk happen,” Brown said in an interview with the BBC.
Drugs typically move through four phases of clinical trials in order to ensure their safety and efficacy in humans. That process can take years, sometimes even more than a decade. Although some pharmaceutical companies are working on fast-tracking the approval process for their Ebola treatments, the reason we don’t already have a vaccine for what’s considered the world’s deadliest disease brings us to yet another question of ethics.
The research and development of new drugs is currently driven by the pharmaceutical industry, which typically chooses to invest in products that are profitable. That means drug companies are more likely to develop treatments that Westerners will buy, like erectile dysfunction drugs, than treatments for rare diseases that plague impoverished African nations.
“I suggest that the real ethical dilemma here is not whether to fast-track approval and production of the Ebola treatment that has been used experimentally, but whether medical research should be funded by a predominantly market-driven system with the work of critical drug discovery left to the underfunded public sector,” Heather M. Ross, a nurse practitioner and a faculty member at Arizona State University, argued in an op-ed published in the Hill on Tuesday.