The race to develop an Ebola vaccine is well underway. In West Africa, several organizations are pushing to get some form of treatment to those in need, even if that means skipping a few steps. The Guardian reported on Thursday that three different experimental Ebola drugs would be tested by volunteer doctors working with Médecins Sans Frontières at treatment centers across West Africa.
Running these trials is a bold and unconventional step for Médecins Sans Frontières and its partners in the trials because the tests will be run in the midst of an ongoing epidemic with drugs that have not gone through the usual gauntlet of clinical trials in animals and healthy humans before being used to treat the sick. Médecins Sans Frontières is working with pharmaceutical companies, academics, and the World Health Organization in an effort to rapidly set up these trials in order to cut the 70 percent death rate from Ebola in West Africa.
Two of the trials will be taking place in Guinea. The first will be led by the French National Institute of Health and Medical Research who will be testing favipiravir, an antiviral drug developed by Toyama Chemical of Japan, in the city of Guéckédou. While the drug was originally developed to fight influenza, it has had a good track record against Ebola as well. The Antwerp Institute of Tropical Medicine will be leading the second trial in Conakry, where they will be analyzing the effects of administering blood and plasma containing antibodies from surviving patients to those who are currently suffering from the disease.
A third trial will be conducted by Oxford University scientists at an undecided location. These scientists will be testing an antiviral drug called brincidofovir, developed by Chimerix of Durham, North Carolina. Although the drug has not been tested on animals, it has shown good results in lab trials against Ebola.
All of the organizations involved are well aware of the risks of administering untested drugs to patients currently sick with the disease. The scientists behind the studies are doing everything they can to curb the high death rate of the disease. “There is a great need for these trials,” claims Professor Peter Horby, the chief investigator of the Oxford trial. “This is tragedy for individuals and communities. We need to do everything we can to offer hope to these communities.”
The first trials are to begin in February, where scientists will be checking to see if the drugs will make a dent in the Ebola death rate. The main factor the researchers will be considering is whether more people infected with the disease survive over a 14-day period than did before the treatment began. If death rates go up, the drug will immediately be cut from the trials. That won’t spell disaster for those at the treatment center because the World Health Organization has a plan to replace any failed drugs with a different one taken from a list of possibilities.
Additionally, none of the trials will be using a control group. During normal clinical trials, a portion of sick people involved in a study are not given the drug administered to the rest of the group. This allows scientists the ability to compare the two groups and get a better understanding of how well the drug functions. However, the extremely high death rate of Ebola has made it a moral imperative to make sure everyone has access to treatment, even if it is experimental.
Unfortunately, none of the current tests will be administering the drug ZMapp, which proved to be very effective at fighting Ebola after it was given to some of the foreign health workers who were infected earlier in the epidemic. ZMapp takes a very long time to produce and is prohibitively expensive. One of the greatest challenges to developing a drug to combat Ebola is to create technology that allows for the rapid development and deployment of effective treatments.