WHO Backs Use of Experimental Treatments for Ebola

Megan Brooks

August 12, 2014

It is ethical to offer unproven interventions with unknown efficacy and safety as potential treatment or prevention in the ongoing Ebola outbreak, a panel of medical ethicists convened by the World Health Organization (WHO) said today.

There was "unanimous agreement" among the 12-member panel that "in the special circumstances of this Ebola outbreak it is ethical to offer unregistered interventions as potential treatment or prevention," Marie-Paule Kieny, PhD, WHO assistant director-general, said during a briefing at the organization's headquarters in Geneva, Switzerland.

The panel said ethical criteria must guide the provision of experimental interventions. These include "transparency about all aspects of care, informed consent, freedom of choice, confidentiality, respect for person and preservation of dignity, and with the involvement of the community," Dr. Kieny explained.

"Far Too Many Lives Lost"

On August 8, the WHO declared the Ebola outbreak raging in West Africa a global public health emergency, as reported by Medscape Medical News.

It is "the most severe outbreak" ever seen, and it has been difficult to bring it under control, Dr. Kieny said.

Identifying all cases, tracing all contacts, and making sure that the people caring for infected people use protective gear at all times has "always stopped this virus in the past, but this outbreak seems to be different," she said. This time around, there are "many more cases and greater spread."

Dr. Kieny said the availability of potential treatments is "another important difference" from past Ebola outbreaks.

"In the past 10 years, research efforts into Ebola treatments and vaccines means that for the first time, we have a range of potential treatments and vaccines that could be potent assets supporting our efforts to control Ebola virus disease," she said. "However, while several of these treatments have proven to be very effective in non-human primates...none have undergone the tests in humans necessary for licensing as proven safe and effective treatment."

"Far too many lives have been lost," Dr. Kieny said, and recent use of some experimental treatments in a few people infected with Ebola has brought this issue to the forefront.

The WHO panel emphasized that there is a moral obligation to collect and share all data generated from any use of experimental drugs in the Ebola outbreak to better understand the safety and efficacy of these interventions.

There is also a moral duty to evaluate these interventions in the "best possible clinical trials under the circumstances in order to definitively prove their safety and efficacy or provide evidence to stop their utilization," the WHO said in a summary statement of the panel discussion posted on its Web site.

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