WHO Experts Give Nod to Using Untested Ebola Drugs
Move would be justified in 'particular circumstances' of current outbreak, ethicists say
By Dennis Thompson
TUESDAY, Aug. 12, 2014 (HealthDay News) -- A panel of ethicists specially appointed by the World Health Organization says it is ethical to give untested treatments to people battling Ebola in the current outbreak.
"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," WHO said in a statement issued Tuesday.
As the number of dead in the West African Ebola outbreak tops 1,000, many people have called for the wider production and release of untested medicines that might help patients.
A precious handful of samples of one such drug, called ZMapp, appeared to boost the recovery of two American aid workers stricken with the viral disease, which has a 90 percent fatality rate.
And on Monday, Spain announced that it had obtained the drug for Miguel Pajares, a Spanish priest who caught Ebola while in Liberia. But Pajares, 75, died from Ebola on Tuesday, the Associated Press reported.
According to the AP, two more samples of the experimental drug are on their way to West Africa to help treat two Liberian doctors stricken with Ebola and should arrive within the next 48 hours.
While agreeing that untested drugs could be ethically used in the ongoing outbreak, the WHO panel did not specify who should get priority to receive them. Instead, they said that "more detailed analysis and discussion" are required to determine how to fairly distribute the limited supply of the drugs.
ZMapp had proven effective in monkeys at fighting Ebola, but it had never been tested in humans.
Responding to demands for wider access to ZMapp and other drugs in the pipeline, WHO convened the expert panel of medical ethicists to decide the issue.
"We have a disease with a high fatality rate without any proven treatment or vaccine," Marie-Paule Kieny, WHO assistant director-general, explained last week in a statement. "We need to ask the medical ethicists to give us guidance on what the responsible thing to do is."
On the surface, the choice seems obvious: Why wouldn't officials use every tool in their arsenal to combat what WHO now labels a "public health emergency"?
But ethicists say there's a hornet's nest of questions involved in making these largely untested drugs available to sick people.
Who would be first in line to get short-in-supply medications? Who will make that decision? How will doctors collect data on how the drugs perform? How do you communicate the risks of an experimental drug to a poorly educated inhabitant of a rural village? And would the money for these drugs be better spent on quarantine supplies and public education, to help prevent disease transmission?