A couple of weeks ago, two US aid workers joined the growing list of those infected in the West African ebola epidemic. However, like the unfolding plot of a movie, these were different. They both received an experimental treatment with dramatic results.
Ebola is the stuff of nightmares. It has the ability to strike terror into even those with zero chance of contracting it. It is no surprise that the recent positive results from the experimental treatment, ZMapp, have drawn a great deal of media attention.
Since March, the current ebola epidemic has claimed over 1,000 lives. The WHO cautiously estimates that a vaccine may be available in 2015 but as yet there is no vaccine or approved treatment.
On 1st August, the US satirical website, The Onion, published a story entitled “Ebola Vaccine At Least 50 White People Away.” Less than a week later the world received the news that two US aid workers were responding well to a new experimental treatment.
Dr Kent Brantly & Nancy Writebol
Biting satire aside, aid workers like these knowingly choose to put themselves in potential danger to help others. It would be crass in the extreme to question the choice of test subjects for the drug, especially without knowing the full facts of the case.
The three-mouse monoclonal antibody had previously only been tested on a small number of monkeys and would have been considered well away from human trials under normal good clinical practice rules. However, both patients gave informed consent despite the risks.
What are the implications for other untreatable diseases?
Are we seeing the dawn of an age in which GCP principles can be effectively circumvented if the disease is sufficiently severe?
If it looks like ZMapp did successfully cure the disease without unacceptable side-effects – what next? Would it be humane to deny hundreds of doomed sufferers an effective treatment merely because it has not gone through the rigors of the normal trials process?
Unfortunately, stocks of ZMapp are already exhausted and the manufacturer has said it will take months to produce even modest amounts of fresh stock.
Dr Brantly had apparently felt so near to death that he had called his wife to say goodbye. If a treatment like this could bring hope to the hopeless, isn’t that precisely what medicine should be about?
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