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© 2014 Global Research |
The 1995 movie "Outbreak" by Morgan Freeman portrayed an Ebloa like outbreak but is manufactured in Hollywood so take it with a pinch of salt. The
six month old Ebola crisis which started in Guinea, has spread to Liberia and Sierra Leone and claimed
about 2,100 lives. It caught the attention of the world but not serious enough move them to
response at the requisite level. This is important as the solution to the problem might lie in the economic and political sphere than medicine.
The
SARS outbreak in 2003 grabbed global attention with a quick world-wide
clarion call coordinated by WHO. The response to Ebola had been tardy and half hear-ted thus far. Voices of politicians have been anything but lip service
literally.
The
reason could be manifold one of which is “The long and ugly
tradition of treating Africa as a dirty, diseased place” written
by Laura Seay and Kim Yi Dionne for The Washington Post. The global community
must rid itself of this old dictum and rise to the occasion by embracing all
human lives as equal. ( but some are more equal
than others; punt intended from Animal Farm).
Ebola’s
historical mortality rate is close to 90% according to WHO but experts are
reporting rates in the neighborhood of 60%-80%
in the field this time round. This could be due to better care. In comparison, SARS actual mortality rate for the 2003 outbreak
was only 9.6%.
Both
diseases have some commonality. Proven preventative (vaccine) and therapeutic treatments
are not available. Only supportive care to help the body fight the disease is
available.
A
number of drugs are in various stages of development but nowhere near
human trial. Some quarters propose deploying them into the field immediately with little to loose in view of such high mortality. Some objections seem valid but others sound frivolous.
Firstly,
it could kill the patient and unleash dangerous novel disease. There is no
Bio-Safety-Level (BSL) facility in the field and accidents might lead to catastrophic outcomes.
Scientist
that live in glass houses are even voicing that there is no means to construct
proper double blind trial test and therefore the outcome is of limited future scientific value.
The
supply is limited and cannot be increased quickly. Decisions on who gets the
drug might be a sociological nightmare.
The
administrators or politicians at FDA in USA do not want a binding precedent that
drug companies might exploit in future. The affected 3 African countries' equivalent
“FDA” are primordial and grossly lacking in scientific capabilities and they are unlikely to be the road block.
The
real life field situation is akin to the movie “Outbreak” but the similarity
ends with the solution. The “Index” primate was located in a remotely improbable
drama fueled by the imagination of the script writer. The extracted anti-gen works
like an elixir in delivering an almost instant cure. The anti-gen was mass
produced and distributed and the day was saved by Morgan Freeman. We are not witnessing such solutions in Africa.
The
solution to the Ebola epidemic in Africa is right in front of us.
Firstly,
it has been proven that with better supportive treatment, the mortality rate goes down drastically. This has been proven
to a small extent by the few cases that were repatriated back for treatment.
Although we cannot be totally sure of the outcome, we are definitely sure that
this course of action have little or no risk but might drain the treasuries as air dropping military field hospitals and personnel is not going to be cheap. Politicians are unlikely to support this because of Not In My Backyard (NIMBY) as the R0 or the measure of infectiousness is low and therefore remote
possibility of Ebola reaching their shores unlike SARS which has a higher R0. In addition, if it does, the collateral damage is minimal as it is easily contained with good health infrastructure.
Secondly,
there is proof to support Ebola as an orphan disease. Since its discovery in 1976,
the number cases is not exactly small but the patients are mostly the poor in
Africa with limited capability to pay for the drug. There is limited incentive for drug
companies to invest in. Other funding channels to fund or co-fund such
initiatives are government, charitable foundations and NGOs. Even with such
assistance, it is not easy to attract talent into such specialties in enough numbers to support a viable infrastructure for such work.
The process from Bench to Bed is an insidiously long process because
drugs are becoming more complex and harder to test for efficacy, safety and
many other factors. Man kind cannot be so myopic and be directed by $ alone.
We might not have a medical cure for Ebola but as a global community, we do have the means to arrest this outbreak by putting enough resources and change cultural norms in Africa. The will to do so by politicians might be weaker as it seems that Africa had brought this upon her self.
Peter Lye aka lkypeter
lkypeter@gmail.com Safe Harbor. Please note that information contained in these pages are of a personal nature and does not necessarily reflect that of any companies, organizations or individuals. In addition, some of these opinions are of a forward looking nature. Lastly the facts and opinions contained in these pages might not have been verified for correctness, so please use with caution. Happy Reading. Peter Lye (c) Peter Lye 2014