Priest Dies of Ebola; UN Debates Treatment Ethics
Tue, 08/12/2014 - 8:21am
A Spanish missionary priest being treated for Ebola died Tuesday in a Madrid hospital amid a worldwide debate over who should get experimental Ebola treatments.
After holding a teleconference with medical experts around the world, the World Health Organization declared it is ethical to use unproven Ebola drugs and vaccines in the current outbreak in West Africa provided the right conditions are met. Its statement, however, sidestepped the key question of how to decide who should get the limited drugs.
Two American aid workers and the Spanish priest who died had gotten a new Ebola drug named ZMapp, which has never been tested in humans. On Monday, the San Diego-based company that makes it said its supply was now "exhausted."
Two more ZMapp treatments were reportedly heading Tuesday to Liberia to be used on two infected doctors - the first Africans to receive the experimental drug.
The U.N. health agency says 1,013 people have died so far in the Ebola outbreak in West Africa of the 1,848 suspected or confirmed cases recorded by authorities. The killer virus - spread by direct contact with bodily fluids like blood, diarrhea and vomit - was detected in Guinea in March and has since spread to Sierra Leone, Liberia and possibly Nigeria.
With news of the three Westerners getting the novel drug, some in West Africa have protested that they are being denied a chance to try it.
"We can't afford to be passive while many more die," said Aisha Dab, a Senegalese-Gambian journalist who was tweeting using the hashtag "GiveUsTheSerum."
Officials in Sierra Leone and Guinea expressed interest in getting experimental treatments but haven't yet asked.
The Spanish missionary, 75-year-old Miguel Parajes, died in Madrid's Carlos III Hospital, the hospital and his order said. The hospital would not confirm that he had been treated with the drug, but his order and Spain's Health Ministry said earlier that he would be. His body will be cremated Wednesday to avoid any further public health risks, the hospital said.
Parajes had worked for the San Juan de Dios hospital order, a Catholic aid group, helping to treat people with Ebola in Liberia when he became ill and was evacuated.
WHO decided it is ethical to use experimental medicines and vaccines in West Africa even though there's no evidence yet that these treatments can actually help fight Ebola and it is possible they could be harmful or have no effect at all.
The agency said the size of the outbreak - the biggest-ever in history- made the experimental use of drugs ethical.
"It seems some of the usual methods we're using ... are not working as well," Dr. Marie-Paule Kieny, an assistant director-general at WHO, said during a press conference Tuesday. "We don't have enough people to rely on the traditional methods if we want to stop the outbreak as soon as possible."
WHO said it was OK to use unproven treatments if patients were allowed to have informed consent, confidentiality and freedom of choice.
The panel said a "more detailed analysis and discussion" are needed to decide who should have access to the extremely limited supply of experimental treatments. WHO also said the world had "a moral duty" to collect evidence about the safety and effectiveness of Ebola treatments in proper scientific trials.
Kieny said it was difficult to judge how the few experimental treatments have been doled out so far.
"I don't think there could be any fair distribution of something available in such small quantities," she said.
She said some companies were speeding up trials of their new Ebola vaccines and there might be some preliminary safety data by the end of the year.
There are a number of Ebola drugs and vaccines being developed but none have been properly tested in humans.
Canada's Tekmira Pharmaceuticals Corp. is developing a drug that targets Ebola's genetic material. The Food and Drug Adminstration, a U.S. regulator, had halted a small safety study with questions about a reaction in healthy volunteers. Last week, Tekmira announced that FDA had modified its restriction, clearing a roadblock to possible experimental use in infected patients, and said it was "carefully evaluating options."
West African nations are struggling to control both the deadly outbreak and the fear it has engendered. Most airlines flying in and out of the Liberian capital of Monrovia have suspended flights amid the unprecedented health crisis.
The Ivory Coast, which shares borders with Liberia and Guinea, banned direct flights from those countries and said it would increase health inspections at its borders.
On Tuesday, Liberian President Ellen Johnson Sirleaf suspended all travel by executive branch officials for one month. She also ordered those already abroad to return home within a week "or be considered as abandoning their jobs," according to a statement.
A U.K.-based public relations firm representing Liberia said the experimental Ebola treatment named ZMapp would be arriving within the next 48 hours to treat the two Liberian physicians.
Some Guineans were angered by the fact that Liberia managed to get some of the experimental drug and blamed their government for moving too slowly.
"The Liberians can count on their government, but Guineans can only count on God in the face of Ebola. Our leaders politicize everything, even diseases," said Assiatou Diallo, a nurse in Conakry.
Cheng reported from London. Jonathan Paye-Layleh in Monrovia, Liberia; Clarence Roy-Macaulay in Freetown, Sierra Leone; Jorge Sainz in Madrid and Boubacar Diallo in Conakry, Guinea, contributed to this report.