The first-sip front-page gives me a heads up on the coming plague with a wonderful profile piece, a hero approved by WHO?
"Global health group backs use of experimental Ebola drugs" by Nick Cumming-Bruce and Alan Cowell | New York Times August 13, 2014
The Constant Gardner gone global?
GENEVA — The World Health Organization endorsed the use of untested drugs to combat the Ebola virus on Tuesday, hours after a Spanish priest who had been supplied with experimental medication became the first European to die in the world’s worst known outbreak of the disease.
Ooooh!
No proven cure or vaccine exists for the Ebola virus, which the WHO says has killed 1,013 people in four West African countries — Guinea, Liberia, Nigeria, and Sierra Leone. Around half of the people infected in the outbreak, first reported in March, have died. Last week, the WHO declared the outbreak a global health emergency.
The Spanish priest, Miguel Pajares, 75, worked in a hospital in Liberia and was the first European to return home after being infected with Ebola. Citing medical confidentiality rules, hospital officials in Madrid declined to say whether the priest had ultimately been treated with the experimental drug, ZMapp, made in the United States, but the Spanish Health Ministry said Monday it had obtained the medication for him.
The provision of ZMapp, a previously untested drug in extremely limited supply, to foreign aid workers evacuated from West Africa has raised broad ethical questions about the disparities in treatment between white outsiders and the Africans who form the overwhelming majority of the victims. Two US aid workers, Dr. Kent Brantly and Nancy Writebol, who were evacuated to Emory University Hospital in Atlanta, received the drug as well, prompting questions from some African officials about why their nations had not received the medication.
On Tuesday, the government of Liberia announced it would receive ZMapp after a request to the United States by its president, Ellen Johnson Sirleaf. It said the drug would be used to treat two doctors battling for their lives against the Ebola virus.
That would be the first known use of the drug to treat Africans, but it also might be the last for a little while. The manufacturer, Mapp Biopharmaceutical, said that it had complied with a request received over the weekend from a West African nation, though it noted in a statement that the available supply of the drug was now “exhausted.”
As we have seen time and again and even alluded to in earlier coverage recently, the elite will hog the antidotes for themselves and get the side benefit of loads of us dying to thin the heard and make them more manageable, as well as opening upon breathing space.
In Geneva, the WHO convened an ethics panel Monday to debate the broader use of untested drugs. In a statement on its website Tuesday, it said that given “the particular circumstances of this outbreak,” the panel had reached a consensus that “it is ethical to offer unproven interventions with as yet-unknown efficacy and adverse effects, as potential treatment or prevention.”
Is there anyone out there who trusts the WHO after 5 years ago?
The panel said the use of untested drugs should be guided by ethical criteria, including transparency about all aspects of the care provided, informed consent of the patient, freedom of choice, and patient confidentiality.
WHO officials said another meeting would be held at the end of the month to deal with another delicate and politically charged question: how to allocate scarce treatments.
And WHO DECIDES?
Dr. Marie-Paule Kieny, assistant director-general of the WHO, said at a news conference in Geneva on Tuesday several drugs and vaccines have shown some promise in animal testing and might conceivably be deployed in the outbreak.
So has massive doses of vitamin C.
However, she said, none “is available in unlimited supplies right now.” She added, “I don’t think that there could be any fair distribution of something which is available in such a small quantity.”
Kieny said that intensifying public health measures to contain the outbreak was more important than drugs.
“It is very important to not give false hope to anybody that Ebola can be treated now,” she said.
The Spanish priest, Pajares, was flown back to Madrid on Aug. 7. A dozen doctors and nurses looked after Pajares, who died Tuesday morning. He will be incinerated in a sealed coffin, without carrying out any autopsy, to reduce the risk of further contagion.
Mapp and the US government, which has financed most of the company’s work, are making plans to increase supplies of ZMapp. But it is expected to take several months to increase supplies, and even then, there may be no more than a few hundred doses available, according to federal officials and corporate executives.
Now things are starting to make $en$e.
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NEXT DAY UPDATE:
"Doctors: Ebola drug poses ‘impossible dilemma’" by SARAH DiLORENZO and MARIA CHENG | Associated Press August 14, 2014
DAKAR, Senegal — Doctors treating a Sierra Leone physician with Ebola defended their decision not to give him an experimental drug, saying Wednesday they feared it was too risky.
Calling it ‘‘an impossible dilemma,’’ Doctors Without Borders explained in detail their decision in response to a New York Times story on the case. It would have been the first time the experimental drug was tried in humans.
The explanation came the same day that another top doctor from Sierra Leone died of the disease, further fueling a debate about how to apportion a limited supply of untested drugs and vaccines and whether they are even effective.
Ebola has killed more than 1,000 people and sickened nearly 2,000 in the current West African outbreak that has also hit Guinea, Liberia, and Nigeria. Many of the dead are health workers, who are often working with inadequate supplies and protection.
At the time the experimental treatment was being considered for Dr. Sheik Humarr Khan, his immune system was already starting to produce antibodies suggesting he might recover, Doctors Without Borders said in the statement. Khan was also due to be transferred to a European hospital that would be more capable of handling problems that might arise, it said.
The experimental drug, ZMapp, is designed to boost the immune system to help it fight the virus. Since Khan’s body was already producing an immune response, the doctors may have feared that any boost would kick it into overdrive.
In the end, the treating physicians decided against using the drug. They never told Khan of its existence because they felt it would be unethical to tell him of a treatment they might not use. Shortly after their decision, however, Khan’s condition worsened, the statement said, and the company providing the medical evacuation decided not to transfer him. He died a few days later, on July 29.
‘‘Every day, doctors have to make choices, sometimes difficult, about treatment for their patients,’’ said the Doctors Without Borders statement. ‘‘Trying an untested drug on patients is a very difficult decision, particularly in the light of the ‘do no harm’ principle.’’
ZMapp has since been used on two Americans and a Spaniard. The California-based company that makes the drug, Mapp Pharmaceuticals, has said that its supplies are now exhausted, and it will take months to produce even a modest amount.
Three people treated and the supply is gone? That stinks.
The drug has never before been tested in humans, and it is not clear if it is effective or even harmful. The Americans are improving — although it is unclear what role ZMapp has played in that — but the Spaniard died Tuesday.
The last known doses of ZMapp arrived in Liberia on Wednesday, carried personally by Foreign Minister Augustine Ngafuan.
Dr. Moses Massaquoi, who helped the Liberian government acquire it, told reporters at the airport that there was enough to treat three people. Previously, the government had said it would only have enough to treat two sick doctors.
They would be the first Africans known to receive the treatment.
While many have called for more experimental drugs to be made available, noting that Ebola patients often have little to lose and so much to potentially gain, others have expressed caution.
$omeone will be gaining $omewhere.
‘‘To use this drug without having any information on its human benefits or dangers runs the risk of mistakenly thinking it is either effective or not based upon anecdotal evidence, a difficulty that could prove disastrous for later in this outbreak or future ones,’’ said Dr. Philip M. Rosoff, director of the Clinical Ethics Program at Duke University Hospital.
Even if the ZMapp supply is finished for the time being, the debate will continue.
Not for some.
Canada has promised to donate 800 to 1,000 doses of its untested Ebola vaccine to the World Health Organization and already questions are being asked about who will get it and how scientists will determine if it works.
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