Should we be sending experimental Ebola treatments to Africa?

If this guy can be believed, this is, shall we say, Very Bad:

In stark, often chilling congressional testimony on Thursday, an official with a relief organization responding to the Ebola crisis in West Africa labeled efforts to control the virus a failure.

Ken Isaacs, a vice president with Samaritan’s Purse, a North Carolina-based Christian humanitarian organization, also said the number of Ebola cases and deaths reported by the World Health Organization are probably 25 percent to 50 percent below actual levels.

As of Thursday, WHO reported that the Ebola crisis ravaging Guinea, Liberia, Sierra Leone and Nigeria had killed 932 people, with 1,711 confirmed and suspected cases.

“Our epidemiologists and medical personnel believe that these numbers represent 25 to 50 percent of what is happening,” Isaacs testified.

Now, it’s possible this Ken Isaacs person is scaremongering, guessing, has the wrong information, etc., so it’s probably a good idea to take his testimony with a grain of salt. But does it matter if he’s right or wrong? The reported figures, the ones Isaacs claims are so far below the actual figures, are bad enough that the WHO has declared the outbreak “an international health emergency.” Health care workers are particularly at risk of contracting Ebola, which creates scenarios where the disease can literally shut down a country’s health care system, which causes a snowball effect and makes it easier for the virus to spread. Medical workers in West Africa are in desperate need of proper protective gear, at the very least.

It’s also past time for us to seriously consider mass-producing whatever medicines are being (successfully, it seems) used on Kent Brantly and Nancy Writebol and sending them to the region.
I get that there are issues of human subjects protections and consent to consider, but if those issues could be overcome in order to treat the two American patients, then they can also be overcome to start treating African patients as well. I’m no medical ethicist, but the WHO is reportedly discussing the implications of the wide use of experimental treatments with people who are medical ethicists, so that’s a good sign. President Obama was asked about sending over one experimental drug, ZMapp, at his press conference on Wednesday and bargled through one of the frankly lamest dodges I’ve ever seen him offer:

Obama said on Wednesday that he lacked enough information to green-light a promising medicine called ZMapp that was already used on two American aid workers who saw their conditions improve by varying degrees.

“We’ve got to let the science guide us and I don’t think all the information is in on whether this drug is helpful,” Obama said. “The Ebola virus, both currently and in the past, is controllable if you have a strong public health infrastructure in place.”

But he said: “the countries affected are the first to admit that what’s happened here is the public health systems have been overwhelmed. They weren’t able to identify and then isolate cases quickly enough.”

“As a consequence, it spread more rapidly than has been typical with the periodic Ebola outbreaks that occurred previously.”

It doesn’t matter to the people dying right now, or at risk of contracting the disease, that in ideal circumstances Ebola can be controlled with a strong public health infrastructure, does it? I’d be all for more American aid to Africa to build that kind of infrastructure, but right now there’s an acute emergency that needs to be handled. He’s on more solid ground on the efficacy question, but even if there isn’t a crystal clear justification for administering experimental treatments to these patients (and, again, not a medical ethicist), it seems like we’re in a gray area at least. Obviously it would be best to know whether or not the drug works before you start administering it, but if we’re applying the “first do no harm” principle, then it’s hard to do real harm to a patient who is dying anyway.

I don’t have a list of reputable charities doing work in West Africa right now (if you do, please drop them in the comments), but Doctors Without Borders is there and, although they say their Ebola relief work is “fully funded,” they’re always a worthy choice for donations. UNICEF is another good choice.

Author: DWD

writer, blogger, lover, fighter

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