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PostPosted: Fri Aug 08, 2014 7:17 pm 
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WHO will meet on Monday, August 11, 2014 to discuss Unregistered interventions for Ebola treatment.

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PostPosted: Fri Aug 08, 2014 7:18 pm 
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Panel discussion on ethical considerations for use of unregistered interventions for Ebola viral disease


8 August 2014

The recent treatment of two health and workers infected with the Ebola virus with experimental medicine has raised questions about whether medicine that has never been tested and shown to be safe in people should be used in the outbreak, and, given the extremely limited amount of medicine available, if it is used, who should receive it.

A number of interventions have been through the laboratory and animal study phases of development. It is likely that ‘first in man’ studies will be conducted over the next 2-4 months. It is also likely that the number of doses available for further study and/or deployment from end 2014 onwards will remain insufficient to meet demand.

On Monday, August 11, WHO is convening a panel discussion of medical ethicists, scientific experts and lay people from affected countries to assess the role of experimental therapies in the Ebola outbreak response.

Issues to be considered include:
• Whether it is ethical to use unregistered interventions with unknown adverse effects for possible treatment or prophylaxis. If it is, what criteria and conditions need to be satisfied before they can be used?

• If it is ethical to use these unregistered interventions in the circumstances mentioned above, then what criteria should guide the choice of the intervention and who should receive priority for treatment or prevention?

Names of those attending will be added shortly.

http://www.who.int/csr/disease/ebola/et ... ussion/en/

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PostPosted: Mon Aug 11, 2014 7:10 am 
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Ebola experimental treatment only for the exceptional
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By Kim Yi Dionne August 10 at 3:55 PM
Image

Kentucky Bioprocessing in Owensboro, Ky, has the ability to be a supplier of ZMapp, an experimental serum aimed at boosting the immune system’s efforts to fight off Ebola. (Jenny Sevcik/ Messenger-Inquirer via Associated Press)

Tomorrow the World Health Organization will convene a phone meeting of experts from around the world to discuss the ethical issues of providing experimental treatment to people suffering from Ebola, a highly fatal disease that is spreading in four West African countries. The WHO phone meeting follows the administration of ZMapp — an experimental serum to fight Ebola — to two American missionaries infected with Ebola in Liberia. Both missionaries are now being treated in the United States, and their health appears to be improving.

Last week my colleague Laura Seay weighed in on the ethics of providing experimental Ebola treatment. Laura and I are good friends and often agree on a number of issues – but our opinions diverged on this issue. In her well-written and well-argued post, she highlights a particular problem rooted in the history of medical research:

In the case of medical trials, ethical researchers are also aware of the long and terrible history of research — often on poor black people who were not asked to give informed consent — that has caused significant harm to study participants. From the Tuskegee syphilis experiment to Pfizer’s disastrous 1996 meningitis vaccine trial in Nigeria, unethical studies that victimize vulnerable persons of African origin abound. Nobody involved in discussions about ZMapp wants to repeat this situation, or to put West African Ebola patients who may or may not be able to meaningfully consent at risk for consequences no one can anticipate.

It is on this issue of experimenting on vulnerable populations that I completely agree with Laura. The terrible history of the use of vulnerable populations by research companies and governments in ways that were not meant to benefit those populations and in fact put those populations through undue harm should keep us alert and vigilant against any action that might bear resemblance.

The point of my departure, however, is seeing the provision of experimental Ebola treatment to West Africans as a question of research ethics rather than a question of treatment ethics. As sociologist Amy Kaler noted in a comment on Laura’s post:

… this piece conflates research ethics with treatment ethics. The situation in west Africa is not a research situation, it’s more analogous to an emergency ward or a disaster zone. The author is quite right that research ethics require participants to be capable of giving fully informed consent, but emergency medical procedures are often carried out on people who are not capable of informed consent. If the man in line ahead of me at Starbucks suddenly fell over and stopped breathing, his ability to consent to medical treatment would not be at issue in making the decision whether to start CPR.

When I say I think West Africans should have access to experimental treatment, I’m not saying that the company manufacturing ZMapp (or the other companies with experimental Ebola treatments) should be allowed to run clinical trials that disregard ethical principles on unhealthy West Africans to learn whether their treatment is effective and safe. Rather, I’m saying that West Africans suffering from Ebola should have the same access to treatment and care that Americans have. (And if the former also happens under conditions that pose no additional risk or harm to patients, that’s fine by me.)


Professor Peter Piot, the Director of the London School of Hygiene and Tropical Medicine, poses for photographs following an interview at his office in central London, England, on July 30, 2014. Professor Piot was one of the co-discoverers of the Ebola virus during its first outbreak in Zaire, in 1976. AFP PHOTO/Leon NEALLEON NEAL/AFP/Getty Images
Peter Piot, director of the London School of Hygiene and Tropical Medicine, has deemed the Ebola outbreak exceptional and called for a “limited deployment” of the best experimental treatments. (Leon Neal/Agence France-Presse via Getty Images)
Leading global health scholars have weighed in. Jeremy Farrar (Wellcome Trust), David Heymann (Chatham House Center on Global Health Security) and Peter Piot (London School of Hygiene and Tropical Medicine) published an op-ed in the Wall Street Journal (ungated) in which they deemed the Ebola outbreak as exceptional and call for a “limited deployment” of the best experimental treatments and offer some guidance on how to provide those treatments while also minimizing harm and working under the constraints of scarcity.

The ethical dilemma that seems more pertinent to me in the current response to Ebola is in the governance of global health inequalities. Jennifer Prah Ruger, faculty at Yale in Medical Ethics and Health Policy, summarized global health inequalities with a few key statistics:

…a child born today in Afghanistan is 75 times as likely to die by age 5 years as a child born in Singapore. A girl born in Sierra Leone can expect to live 50 fewer years, on average, than her Japanese counterpart. The number of African children at risk of dying is 35% higher today than it was 10 years ago. Although the average global life expectancy has increased by 20 years over the past five decades, the poorest countries have been left behind.

The differential treatment of patients in the current Ebola outbreak is but a magnification of the inequality of health provision: White Americans get experimental treatment. Black Africans don’t. In her paper, Ruger tries to identify a moral framework for solving problems of global health justice – and one principle seems rather straightforward: an equal respect for all human life. If there is an equal respect for all human life, why do ethical issues stand as barriers for one population of people, but not for another?

The question of treatment ethics and the inequality in health-care provision that I raise here does not address other issues raised in Laura’s post and others on the ethics of making ZMapp available on a wider scale to West Africans suffering from Ebola (e.g., informed consent, exposing patients to potentially severe side effects yet unknown because of lack of human testing, etc.). I write this to point out that these issues did not stop Kent Brantly or Nancy Writebol from receiving the ZMapp treatment (there are also reports that a Spanish priest infected with Ebola in Liberia and evacuated to Spain will receive ZMapp treatment). The decision on whether Brantly and Writebol could get ZMapp didn’t require the WHO to convene a panel of ethicists. Why must West Africans wait?


If we use an ethical argument to prohibit use of a medical treatment, it should be equally administered. When exceptions are made for people from privileged populations, the ethical problem is less about using an untested treatment and more about equal access to treatment.

http://www.washingtonpost.com/blogs/mon ... ceptional/

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PostPosted: Mon Aug 11, 2014 7:15 am 
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Ebola, research ethics, and the ZMapp serum


By Laura Seay August 6

A Nigerian health official displays a leaflet explaining Ebola Virus Disease (Sunday Alamba/AP)
The ongoing West African Ebola outbreak has, after five months, finally captured global attention, in large part because in late July, three Americans contracted the virus. One, Liberian-American Patrick Sawyer, died in Lagos after flying from Togo. The other two U.S. citizens are health workers at a clinic in Liberia’s capital, Monrovia, who have since been transported for advanced care at Emory Hospital in Atlanta.

Monday brought news that to many seemed miraculous: the Americans being treated at Emory seemed to have been revived – and possibly saved – from Ebola thanks to an experimental serum, ZMapp, that was secretly transported to their bedsides in Monrovia. Dr. Kent Brantly, who had sensed that he was in the end stages of Ebola and about to die when he ingested the serum, was so much improved that he was able to walk from his ambulance into Emory with only minimal assistance. Missionary Nancy Writebol’s symptoms also improved, although it took two doses of ZMapp for her to experience improvement, whereas Brantly only required one.

The news of a possible cure for Ebola is heartening, but it left many observers with mixed reactions. Why were Brantly and Writebol the only Ebola patients to receive ZMapp? The optics of the situation were already bad enough: at great expense, two white Americans were whisked away to safety and a level of health care that simply cannot be provided on the fly in a Liberian hospital. The black Liberians they had been treating were left to see whether fate would save or kill them under the same substandard health care system they have always lived under.

That what now looks like a miracle cure was only given to the white Americans looks even worse. Why hadn’t anyone reached out to try the serum on Ebola patients sooner, especially if its potential to heal is so promising? Is the world of global public health really so biased toward the privileged that Americans get help while everyone else suffers? If nothing else, can we at least start giving ZMapp to as many Ebola-infected West Africans as possible?


There are no easy answers to these questions, and people of good will should be unsettled by the way this unfolded. That said, the dilemmas faced by scientists and public health workers with respect to using ZMapp are complex. Every U.S. researcher who works with human subjects, whether in the social or hard sciences, must abide by a set of strict protocols and regulations. Deviating from these norms can lead to being reprimanded, terminated from employment, and any number of other punitive outcomes. More importantly, it can also significantly harm research subjects, causing them physical and psychological suffering from which they may never recover or be compensated.

What’s at stake for researchers when it comes to ethical testing and deployment of a new treatment? The first and most important principle of ethical research is that the subjects (in this case, Ebola patients) are able to give meaningful informed consent. “Informed consent” means that an individual or community understands what is going to happen if they agree to take an experimental drug or be interviewed for a study or participate in a survey. In general, researchers have to fully inform subjects about what they will be taking, the risks of participation and non-participation, and how the data generated from the study will be used (ie, the findings might be published in an academic journal and promoted in a newspaper).

The trick to informed consent is that it has to be meaningful. It’s not enough to just tell subjects about the study; they need to understand what that means, and to be capable of saying or signing a document saying, “Yes, I understand, and I’m still willing to participate.” This leads us to a second major concern for ethical research: the treatment of vulnerable populations. There are some groups of people who by definition are unable to give meaningful informed consent. These include children, institutionalized persons (prisoners and those confined to mental health institutions), and anyone else who might not be capable of understanding the full implications of their decision to participate in a study.

A Liberian suffering from Ebola would almost certainly be considered to be a vulnerable person by most research ethics boards. Consider these issues. Can someone who is gravely ill and who has never heard of the concept of “informed consent” really fully consider the implications of taking a drug like ZMapp? Could he or she feel coerced because foreign doctors are the ones asking for consent? Does the patient understand that the drug might not work, or might have very negative side effects down the road? Add to this the dilemmas of cross-cultural communication, where misunderstanding is as likely as not, and it is very likely that “consent” becomes meaningless in the context in which the Ebola outbreak is happening.


Compounding these dilemmas is the fact that ZMapp has never before been tested in humans. It was given to Brantly and Writebol under a “compassionate use exemption,” an approval from the FDA that allows a drug that has not been fully tested to be used anyway when a patient may have no other way to survive than by taking the drug. That ZMapp seems to have helped Brantly and Writebol does not change the fact that researchers know almost nothing about how the drug works in humans. It could be the case that the drug saves Ebola patients, but causes another health complication like cancer or dementia five years later. ZMapp might work differently in men than in women, or be more effective when given to the young than the old. It could save adults but kill children. We simply don’t know.

Figuring out these issues requires rigorous testing, which in the drug creation process is most commonly conducted through several rounds of clinical trials. The best studies are randomized control trials, in which some study participants get the real treatment (in this case, ZMapp) while others get a placebo, and researchers follow what happens to each subject to assess the effectiveness of the drug in different kinds of populations. Most Americans are familiar with and understand this concept; someone has to risk unknowingly taking the placebo so we can learn whether the actual drug works.

It is far from clear that citizens of developing countries understand randomized trials in the same way. As lawyer Esther Chang noted in a 2002 paper, developing country participants in clinical trials often do not understand the concept of a placebo or may misunderstand informed consent forms. Journalist Howard French observed such problems firsthand in his observations of a 1997 clinical trial in Cote d’Ivoire of whether and how antiretroviral drugs could prevent transmission of HIV from mother to infant. Most social scientists who do research in developing countries – myself included – have similar stories of subjects not understanding why they are being asked to sign an informed consent form; in their minds, agreement to talk to me is consent. Signing a document also leaves a record, which many subjects fear might somehow be used against them by political authorities, foreign spies, or others who are up to no good.

Those fears are not entirely unfounded in some parts of the world where free speech is not a right subjects can take for granted. In the case of medical trials, ethical researchers are also aware of the long and terrible history of research – often on poor black people who were not asked to give informed consent – that has caused significant harm to study participants. From the Tuskegee syphilis experiment to Pfizer’s disastrous 1996 meningitis vaccine trial in Nigeria, unethical studies that victimize vulnerable persons of African origin abound. Nobody involved in discussions about ZMapp wants to repeat this situation, or to put West African Ebola patients who may or may not be able to meaningfully consent at risk for consequences no one can anticipate.


A final ethical issue concerns accountability when things do go horribly wrong with a drug trial. If Brantly or Writebol experience significant negative side effects from taking ZMapp, they will have avenues for legal recourse in U.S. courts, although these will be limited by the fact that they were able to give meaningful informed consent. Victims of the Pfizer debacle in Nigeria had to fight a lengthy and difficult legal battle to get compensation for their suffering, and there were major legal questions about whether Nigerians could sue a U.S. company in American federal courts. Legal recourse for poor Liberians, Sierra Leoneans, or Guineans would be an expensive and difficult task.

None of this means that ZMapp, if it can be manufactured in larger doses in a quick time frame, cannot be used on other Ebola patients as it was with Writebol and Brantly. The World Health Organization announced today that they are forming a panel of ethicists to consider whether and how ZMapp might be distributed among Ebola patients. There is no doubt in anyone’s mind that the urgency of Ebola, its high fatality rate, and the need to deliver effective treatment as quickly as possible must be taken seriously. Here’s hoping that the WHO ethicists can come to a quick conclusion, that ZMapp can be manufactured quickly, and that the drug will be responsibly distributed in a way that informs patients and their families to the fullest extent possible and allows researchers to learn more about how it works and doesn’t work in human populations. A cure for Ebola would be a wonderful thing indeed.


Laura Seay is an Assistant Professor of Government at Colby College. She studies African politics, conflict, and development, with a focus on central Africa. She has also written for Foreign Policy, The Atlantic, Guernica, and Al Jazeera English.

http://www.washingtonpost.com/blogs/mon ... app-serum/

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PostPosted: Mon Aug 11, 2014 7:17 am 
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niman wrote:
WHO will meet on Monday, August 11, 2014 to discuss Unregistered interventions for Ebola treatment.

Martin Enserink ‏@martinenserink 4m
.@WHO's ethical panel on expt'l #Ebola drugs has press conference this afternoon. The 3 questions they discussed: http://bit.ly/1ooRc59
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WHO ‏@WHO 1m
@martinenserink Hi Martin, press conference is tomorrow, Tues., 12 Aug, 14h00 Geneva time #Ebola

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PostPosted: Mon Aug 11, 2014 7:21 am 
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Experimental Medicine in a Time of Ebola
6 AUG, 2014
tags: David Heymann, ebola, Jeremy Farrar, Peter Piot
by Wellcome Trust

As the deadly outbreak of Ebola in West Africa continues to claim lives, Wellcome Trust director Dr Jeremy Farrar calls for Africans to be given access to experimental Ebola medication. This joint statement with Prof David Heymann, head of the Chatham House Centre on Global Health Security, and Prof Peter Piot, director of the London School of Hygiene and Tropical Medicine, expresses the urgent need for action. It was originally published in the Wall Street Journal.

A virologist carrying out mouse experiments in a lab in Hamburg five years ago accidentally pricked her finger. The syringe contained the Zaire Ebola virus, the same strain wreaking havoc today in Guinea, Liberia and Sierra Leone. There is no approved treatment or vaccine for Ebola, or even one that has passed the first phase of safety trials in human volunteers. Yet unlike those exposed to Ebola in West Africa recently, the Hamburg virologist was quickly offered an experimental vaccine.

This vaccine hadn’t yet been tested on humans, but it had been shown to offer primates some protection against Ebola infections. For the virologist, it wasn’t a good option, but it was the only one available in the face of a virus with an extremely high mortality rate. She chose to take the vaccine.

We expect it is a risk we would take if one of us were exposed to Ebola. The Hamburg researcher didn’t fall ill. It is unclear exactly how the vaccine worked, or indeed whether she was ever infected. What is important is that immediate access to an experimental vaccine allowed her to try something with the potential to protect her.

It is highly likely that if Ebola were now spreading in Western countries, public-health authorities would give at-risk patients access to experimental drugs or vaccines. Indeed, there are reports that two U.S. relief workers infected with Ebola in Liberia have been offered experimental therapies, which they have accepted.

There are antiviral drugs, monoclonal antibodies and vaccines under study that have shown varying degrees of effectiveness in animals that have been infected with or exposed to the Ebola virus. Medical agencies in rich counties affected by Ebola would begin discussions with companies and labs developing these products and then make rapid decisions about which of them might be appropriate for compassionate use.

Ebola virions
This scanning electron micrograph (SEM) depicts a number of Ebola virions.

The African countries where the current outbreaks of Ebola are occurring should have the same opportunity. African governments should be allowed to make informed decisions about whether or not to use these products, for example to protect and treat health-care workers who run especially high risks of infection.

The World Health Organization could assist African countries with developing rigorous protocols for the use and study of experimental approaches to treatment and prevention, while coordinating more traditional containment measures. As the only body with the necessary international authority, it must take on this greater leadership role.

Affected communities would need to be made fully aware regarding treatment options through open and responsible communication. And the international community must work hard to break down the barriers of fear and mistrust. In a region racked by civil war and poverty, international agencies need to be aware of infrastructure limitations, as well as those imposed by cultural and religious sensitivities.

Experimental treatments shouldn’t be rolled out generally without prior safety testing. But in the face of the critical challenge in West Africa, the WHO and Western medical agencies should be helping countries weigh the risks and benefits of a limited deployment of the best candidates to those in the greatest need, while continuously monitoring safety and efficacy.

This epidemic is now so extensive that we can expect it to last for some months yet. That means the West must fast-track safety testing of drugs and vaccines in unaffected countries, so that those which perform well could go into fuller trials in the affected region before the outbreak ends. Even if results come too late to allow trials this time around, this approach would allow studies to begin quickly when Ebola next strikes. Ultimately, the only way of discovering whether these new interventions are effective will be to test them in an Ebola epidemic.

Experimental treatments aren’t a substitute for standard infection-control measures. Past Ebola outbreaks have demonstrated which containment approaches are effective: hospital-infection control, self-protection of health workers, community education about how to avoid infection, and placing those exposed under fever surveillance and isolation for a full 21 days.

These measures, however, have failed to stop the West African outbreak, because of profound distrust in authorities and health services, strong traditional beliefs concerning disease causation and funeral practices, and, until recently, a lack of leadership. Populations have grown, people travel more and there are more people living in major cities—all of which complicate the containment of Ebola and other highly infective diseases and multiply the risks of catastrophic outcomes. These dire circumstances call for a more robust international response.

This comment piece was originally posted in the Wall Street Journal on 5th August 2014. You can hear Prof Peter Piot, who co-discovered Ebola in 1976, talking about the situation in this interview with BBC Radio 4’s Today Programme.

http://blog.wellcome.ac.uk/2014/08/06/e ... -of-ebola/

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PostPosted: Mon Aug 11, 2014 7:50 am 
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EXPERTS MEETING AT WHO
A teleconference held Monday between WHO experts in particular on issues of medical ethics to define a position in front of the urgent appeals to use non-approved médicamements to try to save the sick. Following treatment with the first positive results of two American caregivers and the coming of a Spanish priest brought back to Madrid with one of these drugs designed by the American firm Mapp Pharmaceuticals, calls her employment have increased even if he had never previously been tested on humans and is therefore approved by any health authority.

"Is it ethical to use non-approved drugs, and if it does what criteria should be defined, under what conditions should we administer this treatment and to be treated" , these are some of the questions that this meeting must meet, told AFP Marie-Paule Kieny, Assistant to the Director-General of WHO. It also stresses that the drug is only available in small quantities. It also raises the question of a possible use as a preventive measure for the medical staff.

Monday's meeting, which focused on ethics and called in an emergency, should be followed later by a larger meeting that will explore different avenues of treatment that are currently the subject of research and ways to accelerate their development , said Marie-Paule Kieny.

The most serious since the discovery of Ebola virus in 1976 current epidemic continues to spread. Nigeria, the most populous country in Africa, reported on Monday a new case. This is a nurse who had cared for a deceased July 25 in Lagos Liberian, according to the Ministry of Health. Total two people died in Nigeria. In eastern Africa, Rwanda announced Sunday night that segregated German student hospitalized in Kigali, with symptoms of Ebola disease. The results of tests to which it has been subjected should be available within 48 hours.

To date the epidemic, which is spread through direct contact with blood and bodily fluids of infected humans or animals, has made more than 960 deaths over nearly 1,800 cases (confirmed, probable or suspect) in the four affected countries, according to WHO.

http://www.liberation.fr/monde/2014/08/ ... um=twitter

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PostPosted: Mon Aug 11, 2014 1:35 pm 
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NPR Science Friday on use of ZMapp

http://www.sciencefriday.com/segment/08 ... ebola.html

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PostPosted: Mon Aug 11, 2014 3:45 pm 
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Spanish Missionary Priest Gets Experimental Ebola Drug, Sparking Ethical Questions
The Associated Press | By CIARAN GILES and MARIA CHENG
Posted: 08/11/2014 1:46 pm EDT Updated: 1 hour ago
Image
MADRID (AP) — In a development that raises a host of ethical issues, Spain announced it had obtained a scarce U.S.-made experimental Ebola drug to treat a Spanish missionary priest infected with the killer virus.

The Health Ministry statement came less than a week after the U.S. Centers for Disease Control and Prevention said there were virtually no doses available of the drug that was used to treat two Americans with the disease.

The drug's maker, Mapp Pharmaceutical Inc. of San Diego, says "very little of the drug is currently available" and that is cooperating with government agencies to increase production as quickly as possible.


Nigerian officials say they had asked U.S. health authorities about getting the Ebola drug but were apparently not helped.

There is no known cure or licensed treatment for Ebola, which has killed over 960 people in the current outbreak in West Africa. The World Health Organization has called the Ebola outbreak — which emerged in Guinea in March and has since spread to Liberia, Sierra Leone and possibly Nigeria — an international health emergency and urged nations worldwide to battle the disease.

The ethical questions surrounding experimental Ebola drugs and vaccines were being debated Monday during a teleconference of medical ethicists and other experts organized by the U.N. health agency.

In a statement provided Monday, the Spanish Health Ministry said the ZMapp drug was obtained in Geneva this weekend with permission from the company and brought to Madrid to treat Miguel Pajares. The 75-year-old priest was evacuated from Liberia and placed in isolation Thursday at Madrid's Carlos III Hospital.

Two Americans diagnosed with Ebola in Liberia and evacuated back to the United States have been treated with the drug. One of them, Dr. Kent Brantly, said last week that his condition was improving and the husband of the aid worker being treated with Brantly said the same thing. Both are in isolation at an Atlanta hospital.

It was not exactly clear how Spain got the drug.

Spain said it obtained permission from the laboratory developing the drug and, under an agreement between WHO and the Doctors Without Borders charity group, imported the drug from Geneva where it said a dose had been available. The ministry said Spain sought the drug under legislation permitting use of unauthorized medication in patients suffering from a life-threatening illness who cannot be treated satisfactorily with any authorized drug.

WHO spokesman Gregory Hartl, however, told The Associated Press on Monday that the U.N. agency had no role in helping Spain obtain the experimental drug.

At least one country in West Africa has expressed interest in the Ebola drug. Nigeria's health minister, Onyenbuchi Chukwu, said last week he had asked U.S. health officials about access but was told the manufacturer would have to agree.

Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said "there are virtually no doses available," a CDC spokesman said last week.

Because the ZMapp drug has never been tested in humans, scientists say there's no way to tell if it has made any difference to the two American aid workers who have received it.

The drug is a mixture of three antibodies engineered to recognize Ebola and bind to infected cells so the immune system can kill them. Scientists culled antibodies from laboratory mice and ZMapp's maker now grows the antibodies in tobacco plants and then purifies them. It takes several months to even produce a modest amount of the drug.
In other Ebola developments:

— Nigerian health authorities confirmed another Ebola case Monday, a nurse who was treating Patrick Sawyer, the Liberian-American who flew into Nigeria with the disease and died of it last month. That brings the locally confirmed Ebola cases in Nigeria to 10, including two who have died, Sawyer and another nurse. Nigerian authorities now have 177 contacts of Sawyer under surveillance. WHO has not yet confirmed the Ebola cases in Nigeria.

— The hemorrhagic disease is ravaging some of the world's poorest countries, and their ill-equipped health systems have struggled to keep up. Liberia announced that a donation of protective gear from China was arriving Monday. A shortage of full-body suits and even clean surgical gloves has left health workers exposed to the virus and prompted some to refuse to treat Ebola patients.

— Residents in central Liberia rioted over the weekend, claiming the government had left some highly infectious bodies of Ebola victims in the streets for days without picking them up.

— George Weah, a former FIFA world player of the year from Liberia, has joined the efforts to spread awareness about the disease and how to prevent it. He recording a song titled "Ebola is real," and proceeds are going to the Liberian Health Ministry.

___
Medical writer Cheng reported from London. AP writers Jonathan Paye-Layleh from Monrovia, Liberia and Bashir Adigun from Abuja, Nigeria, also contributed to this report.

http://www.huffingtonpost.com/2014/08/1 ... mg00000067

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PostPosted: Mon Aug 11, 2014 3:46 pm 
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Emergency meeting on the role of experimental therapies in outbreak response

On Monday 11 August, WHO is holding an emergency meeting with ethicists, scientific experts and lay people from affected countries to assess the role of experimental therapies in the Ebola outbreak response. Issues to be considered include the ethics surrounding use of therapies when safety is unproven, ethics governing priority setting for access to these therapies and principles for fair distribution.

http://www.who.int/csr/disease/ebola/ov ... t-2014/en/

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