by Dish Staff
Doctors Without Borders physician Armand Sprecher argues that it would be unwise to administer the unproven Ebola treatment ZMapp to every West African patient:
If the patients have a more than seventy percent chance of dying, why not try something, even if it is not guaranteed to work? One reason is that doctors have a limited amount of time that we can spend with our patients. … There is not a lot of extra time to experiment with unproven therapies. And there are many such therapies. Dozens are brought to my attention with every outbreak. Some have shown promise in rodent models, others in test tubes, and some are of only theoretical benefit. Experience has shown that such potential almost always fails to produce a benefit in non-human primate studies, our best analog of human disease. We cannot subject our patients to all of the possible things that might work. We have to choose wisely.
It is not because these drugs are expensive or intended just for North Americans and Europeans that they are unavailable to Africans. They are unavailable because they are not yet ready.
For the antibodies used for the two Americans, only a handful of treatments exist in the world. None of these drugs has gone through the clinical trials needed for their approval for use by drug regulatory agencies. Médecins Sans Frontières hopes to play a role in facilitating the eventual trials that will bring these drugs to market, and from there to see to it that they are made available to the patients that need them.
Meanwhile, Jason Millman examines how public health organizations are working to incentivize companies to develop cures for diseases such as Ebola:
The [World Health Organization] has looked into a “prize fund” approach, among other ideas. Under this model, a centralized fund would reward drug manufacturers at the end of the drug development process or for hitting research and development milestones along the way.
The United States has its own efforts, too. In 2007, the Food and Drug Administration created a voucher program meant to encourage the development of cures for neglected diseases — if a company receives FDA approval for such a drug, the company would then receive a voucher to speed up the agency’s review time for another drug application. However, just four vouchers have reportedly been awarded under this program so far. The National Institutes of Health has also run the Rare Diseases Clinical Research Network since 2012 to try to fill in the funding gap. The NIH network is studying about 90 rare diseases at almost 100 U.S. and international academic institutions, according to an agency fact sheet.
On a related note, New Scientist‘s Andy Coghlan observers that the specific way Ebola kills “has only just been discovered.” He explains:
In essence, the virus blocks what would usually be an instant response to infection, paralyzing the body’s entire immune system … Normally, the body responds to infections by producing a substance called interferon, which acts as a fast-track message to white blood cells, telling them to mobilize genes and proteins. [Researcher Gaya] Amarasinghe’s team found that the Ebola virus produces a substance called VP24, which blocks the channel through which interferon usually travels, crippling the immune system. With its usual protective mechanisms knocked out, a cell is then defenseless against the virus. Amarasinghe says that drugs which target VP24 might provide alternative ways to combat the virus.
Recent Dish on Ebola here.