WHO backs use of untested drugs on Ebola virus

The World Health Organisation yesterday endorsed the use of untested drugs to combat the Ebola virus, just hours after a Spanish priest who had been supplied with experimental medication became the first European to die in the world's worst known outbreak of the disease.

No proven cure or vaccine exists for the Ebola virus, which the WHO says has killed 1,013 people in four west African countries: Guinea, Liberia, Nigeria and Sierra Leone. About half of the people infected in the outbreak, first reported in March, have died. Last week, the WHO declared the outbreak a global health emergency. The Spanish priest, Miguel Pajares (75), worked in a hospital in Liberia and was the first European to return home after being infected with Ebola.

Citing medical confidentiality rules, hospital officials in Madrid declined to say whether the priest had been treated with the experimental drug, ZMapp, made in the United States, but the Spanish health ministry said it had obtained it for him.

Ethical questions

The provision of ZMapp, a previously untested drug in extremely limited supply, to foreign aid workers evacuated from west Africa has raised broad ethical questions about the disparities in treatment between white outsiders and the Africans who form the overwhelming majority of the victims.

Two US aid workers, Dr Kent Brantly and Nancy Writebol, who were evacuated to Emory University Hospital in Atlanta, received the drug as well, prompting questions from some African officials about why their nations had not received it.

Yesterday the government of Liberia announced it would receive ZMapp after a request to the United States by its president, Ellen Johnson Sirleaf. It said the drug would be used to treat two doctors battling for their lives against the Ebola virus.

Supply ‘exhausted’

That would be the first known use of the drug to treat Africans, but it also might be the last for a little while. The manufacturer, Mapp Biopharmaceutical, said it had complied with a request received over the weekend from a west African nation, though it noted in a statement that the available supply of the drug was now "exhausted".

In Geneva, the WHO convened an ethics panel on Monday to debate the broader use of untested drugs. In a statement on its website yesterday, it said that given “the particular circumstances of this outbreak,” the panel had reached a consensus that “it is ethical to offer unproven interventions with as yet-unknown efficacy and adverse effects, as potential treatment or prevention”.

The panel said the use of untested drugs should be guided by ethical criteria, informed consent of the patient, freedom of choice and patient confidentiality.

– (New York Times service)