Ebola outbreak: time to try experimental drugs, Jeremy Farrar says

With deaths from Ebola virus soaring to 467 in West Africa, and Doctors Without Borders warning the outbreak is spreading "out of control," pressure is growing to offer experimental medicines to the sick and dying.

Jeremy Farrar, a professor of tropical medicine and director of The Wellcome Trust charity, said global health authorities should rethink their approach to potential treatments.

"We have more than 450 deaths so far — and not a single individual has been offered anything beyond tepid sponging and 'we'll bury you nicely'," Farrar told Reuters in an interview. "It's just unacceptable."

His remarks come as the World Health Organization (WHO) — which is warning other states to prepare for Ebola heading their way — hosts a meeting of West African health ministers in Ghana this week to try to strengthen the region's response.

The normal drug development process — of years of testing new drugs in animals, then in healthy human volunteers before they are tested patients and approved by regulators — takes too long and should not apply in rapidly spreading outbreaks of diseases like Ebola, Farrar said.

It's ridiculous that we haven't got these (experimental) products out of labs and animal trials and into human testing.- Jeremy Farrar

West Africa is battling its deadliest outbreak of Ebola, which causes fever, vomiting, bleeding and diarrhea, and can kill between 50 and 90 per cent of those it infects.

Farrar pointed to several experimental drugs and vaccines in development by U.S.- and U.K.-based companies as potential treatments or preventative measures against Ebola, and questioned why they were not being tested in a situation where people at high risk might benefit.

"It's ridiculous that we haven't got these (experimental) products out of labs and animal trials and into human testing, and at least offered to people," he said.

The pipeline of drugs being developed for Ebola is far from bulging — partly due to a lack of research money for a medicine which is likely to be needed mainly in poor countries with scant healthcare funds.

But several small biotech companies and U.S. university departments are developing potential vaccines, and Tekmira Pharmaceuticals, which teamed up with the U.S. Department of Defence on an injectable drug for Ebola, started an initial Phase I trial in healthy volunteers in January.

U.S.-based Inovio and privately held Vaxart are among those with experimental vaccines in animal testing, while GlaxoSmithKline last year acquired Swiss vaccine firm Okairos with an early-stage Ebola product.

Will happen again

Farrar noted that while Ebola is a relatively rare disease, outbreaks have come regularly since the virus was first identified some 40 years ago, and can be predicted to happen in future — making testing potential drugs a sensible approach.

"This is not the first time this has happened, and it will happen again — we know that," he said.

"And we could all have pushed for having stockpiles (of experimental drugs) maybe held in Geneva, and they could have had WHO ethical approval, and then we'd be ready to go (when the next outbreak comes)."

The WHO said on Tuesday it believed three key factors were contributing to the spread of Ebola in the region:

• The burial of victims in accordance with cultural practices and traditional beliefs in rural communities.
• The dense population around the capital cities of Guinea and Liberia.
• Commercial and social activity along the borders of the three countries.

Fear and mistrust are also driving dozens of victims to evade treatment, frustrating foreign and local doctors trying to contain the epidemic.

Doctors Without Borders says Ebola is "out of control," located in at least 60 places across Guinea, Liberia and Sierra Leone.

Basic methods

Both the WHO and Doctors Without Borders (also known as Médecins Sans Frontières), which has been heavily engaged in handling the outbreak on the ground, have said the top priority must be containing Ebola with basic but vital infection control measures such as vigilant hand washing and hygiene, and isolation of infected patients.

Farrar acknowledged these were crucial, but said health organizations need to consider experimental drugs in their planning for the future.

"There are candidate vaccines out there, and candidate drugs, and whilst I absolutely agree that the most important things are infection control and making sure people can't pass it on, ultimately you do have to move these things (candidate drugs) out and start offering them to people," he said.

A University of Texas Medical Branch researcher, Tom Geisbert, told Reuters in March he was developing a potential Ebola vaccine, which had shown good results in animal tests and could, he said, be offered on "compassionate grounds" to people at risk in the current outbreak.