Médecins Sans Frontières (MSF) says it stands ready to order hundreds of thousands of doses of antiviral vaccines to help in the fight against Ebola at the conclusion of trials that will be launched in the coming weeks, and has urged the markers of the drugs to give them away cheaply.
The drugs – brincidofovir, made by the US firm Chimerix, and favipiravir, which is produced by Japan’s Fujifilm – are already used to treat diseases including smallpox, but are also thought to be effective against the Ebola virus, which has already killed at least 5,147 people.
Two separate trials will take place in two of the countries that have suffered the heaviest death tolls, Liberia and Guinea. The third trial, led by the Antwerp Institute of Tropical Medicine in Guinea, will see how well blood plasma taken from Ebola survivors works in curing those infected.
A number of experimental treatments have already been used, including the US-produced ZMapp. Its usage, which proved to be largely effective, drew criticism after it was mainly given to Westerners who had contracted Ebola while working in West Africa.
“The current stabilisation [of the outbreak] is fragile and we are preparing for the worst-case scenario, where we would have tens of thousands or hundreds of thousands of cases to manage. We are anticipating a possible production of hundreds of thousands of doses,” Julien Potet, policy adviser at MSF, told The Independent.
See the Ebola outbreak mapped
See the Ebola outbreak mapped
1/7 25 March 2014
This outbreak of the Ebola virus first emerged in the Guéckédou region of Guinea, at a crossroads with both Liberia and Sierra Leone
2/7 31 March
On 31 March the WHO confirmed the outbreak was now international, spreading first into Liberia's northern-most Lofa region
3/7 27 May
The virus spread to Sierra Leone at the end of May - just as agencies were hoping the worst was over
4/7 27 July
In Sierra Leone the virus boomed, and then it spread to Nigeria when the Liberian diplomat Patrick Sawyer flew from Monrovia to Lagos
5/7 9 August
The Nigeria cases sparked fears around the world, and there have now been deaths in Spain and Saudi Arabia involving people who had travelled to West Africa. The numbers of cases continue to rise
6/7 17-20 September
In mid-September, Senegal confirmed its first case linked to the Ebola outbreak, a development the WHO described as a top priority emergency. Numbers of cases continued to grow exponentially in Guinea, Sierra Leone and Liberia, as experts warned they could number one million by January if not contained
7/7 8 October
Two cases of Ebola have now been reported in the US and Europe - the first times the virus has been contracted among health workers outside Africa
While the drugs are relatively easy to manufacture, MSF has urged drug makers to scale up production now, to try to ensure there is no gap between the end of the trials – which it anticipates will be successful – and any large-scale introduction of the medicines.
MSF confirmed both pharmaceutical companies were “establishing partnerships” with a view to speed up production. The charity sector and the drugs companies are also in discussions about the price of the drugs, which NGOs are trying to procure at cost price, or less. Nonetheless, it will take “a couple of months” between order and deployment of the drug, MSF said.
“The companies need to take the risk of producing in larger quantities, but because there is a market outside of Ebola for these drugs, that risk is minimal,” said Mr Potet.
“If the trials are positive, it is not a question of having the 281st patient being refused access to the drug. Legally, the companies have agreed in principle to give access to the drugs to patients in our centres between these small clinical trials, and eventually a larger-scale one.” MSF says it wants to be assured that the pharmaceutical companies, “would give us access to the drugs on a compassionate and a friendly basis or outside the framework of a clinical trial until the next phase of clinical trials can be implemented”.
MSF, the World Health Organisation and the University of Oxford are also calling for the creation of financing and distribution mechanisms for the drugs, based on existing stockpiles of cholera or yellow fever vaccines.
“We are in countries with very limited resources, so we can expect an international donor will pay to buy these drugs, but we’d like to have a warranty that financing will continue in the medium and long term,” Mr Potet said.
However, Piero Olliaro, visiting professor at the University of Oxford and a research manager at the WHO-based programme for tropical diseases said: “You cannot expect these companies to donate the drugs because of their size, so it is a public responsibility to come up with a plan to subsidise that.”
In a rare piece of good news, the Liberian President Ellen Johnson Sirleaf has ended the country’s state of emergency she imposed three months ago but said the fight not over. Fujifilm and Chimerix could not be reached for comment.Reuse content