Experimental Ebola Treatments Are Ethical, U.N. Says
The use of experimental, unproven drugs to treat the Ebola virus is ethical, a panel of medical ethicists convened by the World Health Organization found on Tuesday.
The United Nations health agency’s statement comes hours after a Spanish missionary priest, who was being treated for Ebola with the experimental drug ZMapp, died on Tuesday in a Madrid hospital.
“In the particular circumstances of this outbreak, and provided certain conditions are met, the panel reached consensus that it is ethical to offer unproven interventions with as yet unknown efficacy and adverse effects, as potential treatment or prevention,” reads a WHO statement.
The panel, consisting of 12 participants representing five continents, was convened after two American health-care workers operating in West Africa contracted the virus and were given an experimental “serum,” which was never before tested on humans, before they were flown back to the U.S. Liberian officials announced on Monday that the country would soon receive doses of the experimental Ebola drug and give it to two sick doctors there as well — the first non-Westerners to receive the drug.
“There’s no reason to try this medicine on sick white people and to ignore blacks,” said Marcel Guilavogui, a pharmacist in Conakry, Guinea. “We understand that it’s a drug that’s being tested for the first time and could have negative side effects. But we have to try it in blacks too.”
Some are using Twitter to demand that the drug be made available.
“We can’t afford to be passive while many more die,” said Aisha Dabo, a Senegalese-Gambian journalist who was tweeting using the hashtag “GiveUsTheSerum”on Monday. “That’s why we raise our voice for the world to hear us.”
The Americans are said to be improving, but there’s no way to know whether the drug helped, or if they are getting better on their own, as others have. Around 40% of those infected with Ebola are surviving the current outbreak.
The panelists were tasked with two questions, according to the WHO’s website:
Is it ethical to use unregistered interventions with unknown adverse effects for possible treatment or prophylaxis? If it is, what criteria and conditions need to be satisfied before they can be used?
If it is ethical to use these unregistered interventions in the current circumstances, then what criteria should guide the choice of an intervention and who should receive priority for treatment or prevention?
The panel, which included medical ethicists, scientific experts and lay people, listed the ethical criteria that must be met in such interventions, stating the importance for transparency, informed consent, freedom of choice, confidentiality, respect, preservation of dignity and involvement of the community in using experimental treatment on Ebola victims.
As of Tuesday, there have been 1,848 reported cases of Ebola, and 1,013 of those infected have died, according to the U.N. health agency. Four West African countries — Guinea, Liberia, Nigeria and Sierra Leone – have been at the center of the latest outbreak.
The panel also expressed that there exists a “moral obligation to collect and share all data generated,” including in cases for “compassionate use,” such as the experimental serum given to the two Americans suffering from Ebola and flown back to the states.
Two medical ethicists who spoke to Mashable before the WHO’s panel released its findings agreed the drug, called ZMapp, was worth trying. And both expressed a desire for data collection — to use an experimental drug without ethically tracking the results would be a waste.
“I certainly don’t object to it, and I certainly understand the motivation to using it,” said Steven Joffe, MD, vice chair of Medical Ethics at the University of Pennsylvania Perelman School of Medicine. “I do think that this would go best if it were carefully studied as it were used, because to just throw it into people and not use every means available to learn about the outcome would be a mistake.”
“The good news is that they didn’t die right away. However it is far from clear that the drug is a success,” said Arthur Caplan, a founding director of the Division of Medical Ethics in NYU Langone Medical Center’s Department of Population Health. “Without more studies we’re not going to know what to do.”
Dr. Joffe, however, said researchers should be using every means at their disposal to learn as much as possible.
“I know it’s really hard to do research in extreme emergency conditions, but do whatever you can to find the minimum amount of information you can get,” he said. “We don’t want to be in situation in five years from now where anything comes up. We gotta know about it.”
BONUS: The Ebola Outbreak: What You Need to Know
The Associated Press contributed to this report.