Experimental Ebola drugs to be used

Senior matron Breda Athan in the high-level isolation apparatus available at the Royal Free Hospital in London. Picture: PA

West Africa is currently experiencing the most severe and complex outbreak of Ebola in history and if conditions are met – such as informed consent – it is ethical to offer “unproven” interventions, the panel of ethicists, medical experts and laypeople concluded.

The panel said research efforts had been invested in developing drugs and vaccines for the disease over the past decade with some showing “promising” results in the laboratory, but they had not yet been evaluated for safety in human beings.

“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,” the UN health agency said in a statement.

“Ethical criteria must guide the provision of such interventions. These include transparency about all aspects of care, informed consent, freedom of choice, confidentiality, respect for the person, preservation of dignity and involvement of the community.”

The panel, which includes UK experts Professor Peter Smith, of the London School of Hygiene and Tropical Medicine, and Professor Jeremy Farrar, director of the Wellcome Trust, added that there was a “moral duty” to evaluate interventions in the “best possible clinical trials under the circumstances”.

The findings have been released amid growing demands for an experimental treatment to be made available to Africans amid a rising death toll from the disease which has been declared a public health emergency by WHO.

The virus has no known cure and causes symptoms including fever, vomiting, muscle pain and bleeding. It is spread by direct contact with bodily fluids like blood, sweat, urine, saliva and diarrhoea. Around 40 per cent of those infected are surviving the current outbreak.

The outbreak has centred on Liberia, Sierra Leone, and Guinea.

So far 1,013 people have died and 1,848 suspected, probable or confirmed cases have been recorded. Nigeria, Africa’s most populous country, has confirmed 10 cases.

Two American aid workers diagnosed with the disease while working in a hospital that treated Ebola and a Spanish priest, Father Miguel Pajares – all of whom were evacuated back to their home countries – are believed to have received the US-made experimental drug Zmapp. In spite of this, Fr Pajares died yesterday in Madrid.

Professor Jonathan Ball, professor of molecular virology at the University of Nottingham, said the panel’s findings did not come as a “huge surprise”.

But he warned that using experimental therapies was not without risks, including that of generating “mistrust” among African countries.

“You certainly cannot say definitively that something which works and is safe in animals will work and be safe in humans. I think there is a risk,” he said.