Ebola outbreak: Two American doctors to be treated with trial drug ZMapp in West Africa

The medics will be treated with the experimental serum ZMapp, but the affected countries do not have the resources to combat the world’s worst outbreak of the disease

Health Correspondent

Experimental drugs never before tested in humans can be used to treat Ebola victims in West Africa, the World Health Organisation (WHO) has said, as the death toll from the worst outbreak of the virus in history rose above 1,000.

The WHO’s decision, a reflection of the unprecedented scale of the crisis, means that an experimental serum, which has already been used on three Ebola patients – two Americans and a Spaniard – will be dispatched to affected countries. However, the US manufacturer said that its very limited stock of the drug had already run out, and that it would take months to develop more.

Liberia said it would be the first African country to receive the drug, known as ZMapp. However, it will only be used on two doctors who have given their consent. The manufacturer, a San Diego biopharmaceutical firm Mapp, said that a delivery to an unnamed West African country had exhausted its supply, which is thought to have amounted only to around 10 doses. There is no cure for Ebola, but some victims do survive.

The WHO’s ethics panel said that there was “a moral obligation” for health authorities to collect and share data on the effectiveness of experimental drugs deployed in the current outbreak.

Efforts to combat the disease with untested medicine could in effect become the biggest ever clinical trial of drugs to combat Ebola. The rarity of the disease, and the fact it has only ever affected poor African countries, means there is a paucity of clinical evidence on effective treatments.

 

Amid growing anger in West Africa that, until today, the only people to receive ZMapp have been Westerners, one WHO official said that shortage was a result of “market failure”. 

“It’s a market failure because this is typically a disease of poor people in poor countries and so there is no market,” said Marie-Paul Kieny, assistant director general of the WHO. 

As a result there are “no clinical stockpiles”, she said, calling on manufacturers and governments to “accelerate development and scale up” as quickly as possible.

However, the drug has had mixed success so far. Two American aid workers treated with it are said to be improving after being repatriated to the US. But a Spanish missionary priest, 75-year-old Father Miguel Pajares, who had been treated with ZMapp at a hospital in Madrid, has died, it was announced today.

Despite early media reports of a “miracle” drug, some experts are sceptical that the experimental treatment can play a major role in combating the outbreak. In a statement, released following a high-level meeting of infectious disease experts and ethicists, the WHO said that it remained the case that the Ebola outbreak could be contained by “available interventions like early detection and isolation, contact tracing and monitoring and adherence to rigorous procedures of infection control”.

Spanish priest Miguel Pajares, who has died from Ebola, with a patient in Liberia Spanish priest Miguel Pajares, who has died from Ebola, with a patient in Liberia (EPA)
The failure of the three countries worst hit by the outbreak – Guinea, Sierra Leone and Liberia – to slow the spread of Ebola is largely attributable to failure to implement such measures effectively.

In Liberia, ministers have said the healthcare system has been “overtaxed and overstretched” by Ebola, and all three countries have been forced to introduce extreme infection control measures. Guinea has shut its borders with its two Ebola-hit neighbours, while Sierra Leone and Liberia have both deployed the military to control movement from the worst-hit rural communities into urban centres.

Since the end of last month, when the virus spread to Africa’s most populous country, Nigeria, headlines around the world have focused on the risk of the disease spreading beyond Africa, but Fr Pajares remains the only European person to die in the outbreak. In the meantime, the death toll in West Africa has continued to mount. The WHO said that the number of confirmed, probable or suspected cases had risen to 1,848, with 1,013 deaths – a mortality rate of 55 per cent.

Some aid agencies have been critical of the international response to a disease that has struck three countries with poorly developed healthcare systems. Médecins Sans Frontières has said that lives are being lost because of the slow response and the WHO has warned about shortages of even the most basic medical equipment required to stop the virus spreading to healthcare workers treating victims.

The outbreak, which began in Guinea, has been growing since February, but it is only in recent weeks that aid commitments have been stepped up. Last week the World Bank pledged £120m in emergency aid funding to Guinea, Sierra Leone and Liberia to contain the spread of Ebola and also to support communities hit economically by the outbreak.

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