The second paragraph does a good job of summing up ethical concerns related to this particular outbreak (standard ethical concerns also apply):
"The first two patients to be treated were Americans. Prior to this came the old (and historically justified) fear of testing potentially dangerous new treatments on vulnerable populations in developing countries rather than on privileged first world patients. The first ever treatment was not given to an African doctor because of this concern [1]. After Westerners were treated, complaints rose about giving infected Westerners access to a new drug while infected Africans went without. These two concerns are obviously mutually exclusive. People are concerned, they are just not sure about what, sometimes even voicing both concerns in the same article [2]."
This is an argument for animal testing?
Treating an ebola patient who has a bunch of weird side effects caused by an experimental drug makes a sub-optimal situation much worse.
I guess the OP's point was how much more sub-optimal can the situation get if the alternative to not trying the experimental drug is the death of the patient.
The first four paragraphs describe what happened: different decisions were made by different doctors, and the drug did not "get out of the shadow only when there was a need to cure an American".
that is exactly my point. It is a discernible trait of the system level behavior with many different people involved.
Sounds like they're already doing precisely that.
EDIT: Very curious whether the downvoters (a) don't get the sarcasm, (b) get the sarcasm and are offended that I question their religious tenets, (c) think animal testing is justifiable beyond reproach, (d) disagree that monkeys are sentient, (e) think that monkeys consent to testing, or (f) just don't like how I worded things.
To me, this is the single most interesting and impressive fact. It's also likely the main reason why "the limited supplies will not help the 20,000 people predicted to be infected during the outbreak in West Africa." Scaling production of antibodies grown in plants can't possibly be straightforward.
"Accelerated Manufacture of Pharmaceuticals (AMP), companies in four states are building facilities where they can quickly produce vaccine-grade proteins grown in the cells of tobacco plants. Once they produce the proteins, the goal is for each company to scale up its process to produce 100 million doses of H1N1 flu vaccine per month."
Tobacco is not scaleable for rapid response because of the amount of time it takes to verify and grow a plant clone. The goal with pandemic flu is to get a rapid response vaccine kit for first responders, then to stage in higher-scaled vaccines. [1]
Ebola is similar. Unfortunately ZMAPP has this technical debt where their testing and validation is tied (understandable from a scientific and legalistic viewpoint but maybe not necessary the best outcome) to production in tobacco. There are better systems now, I'm thinking the new system called 'pichia glycoswitch'.
[1]http://stm.sciencemag.org/content/5/185/185ra68.short Disclaimer: i used to work for the VI and witnessed the researcher D. Gibson come in after the 'timed experiment', where he had a special fedex truck come in at 3am to pick up the package from his private residence; he joked that his neighbors must have thought he was dealing drugs. Although I generally dislike the scientific product coming out of the VI, this was one I had immense respect for.
In some ways it is though. Research using marijuana is currently illegal, even if it gets FDA approval. And if tobacco were similarly illegal, then this research also could have never happened.
When I last looked at this, during the swine flu pandemic, companies typically get 3 doses of antigen per egg.
And this is a very slow process for new strains, first a seed culture has to be created by serious specialists that will both grow well in eggs (can be hard for avian flu...) and expresses the correct surface antigens.
Much better approaches like this company's https://en.wikipedia.org/wiki/Protein_Sciences are desperately needed if a killer flu is someday brewed (this tends to happen in an animal that is simultaneously infected with two strains of flu, so it's not mutation per se).
All true, but once one understands the microbiology, it becomes obvious why drug companies are giving up on antibiotics. It's perfectly rational behavior -- no matter what antibiotics we invent, the microbes will evolve resistance to them in a short time. That's been the history of antibiotics until now, and there's no reason to expect the future to be any different -- if anything, it will probably become worse.
http://www.pbs.org/wgbh/pages/frontline/health-science-techn...
Title: "Dr. Arjun Srinivasan: We’ve Reached 'The End of Antibiotics, Period'"
Why doesn't it get more press? I don't know for sure, but it is:
- Ongoing, which makes for bad news
- Kind of depressing, because we are slowly losing the battle
- Feels a little bit hopeless, because foolish choices by individuals accelerate the development of resistance, and inventing new antibiotics doesn't fix that fundamental problem
I've personally spoken to a couple of GPs/Docs and they said after a few hours of people coming in and asking they get tired and give in.
Between that and farms using them like M&Ms (smarties ;-) ) on the cattle it seems like people are taking a precious resource and throwing it on the floor.
Secondly, if it weren't for this outbreak, all of these treatments and vaccines would likely sit around in clinical trial hell for quite a while.
Cynically speaking, since clinical trials are so risky and expensive, its best if the developers can off-load some of that risk and expense. Picking something like Ebola, surviving on government funding (because its seen as strategic), and waiting for an emergency to allow you to skip a lot of red tape, and get dollops of support, isn't really a terrible choice.
Oh, and antibiotics are hard. For an overview of the current state of antibiotic development, you can take a look here:
http://www.pewtrusts.org/en/research-and-analysis/issue-brie...
Note that 43 drugs are in the pipeline.
http://www.nytimes.com/2014/08/30/world/africa/study-says-zm...
It mentions that all 3 control group animals died.
Does anyone know why the control group is so small compared to the test group of 18?
Monkeys are also very expensive animals to do research on, and no one likes to kill them, or at least we don't tend to have the same sentiments about mice and rats.
It wouldn't surprise me if there were actually six test groups of three animals each (perhaps divided by both day-of-treatment and something else like drug amount), thus matching the control. But the article doesn't actually imply that.
Plus the way this epidemic is playing out in the 3 major countries makes the figures altogether iffy (Nigeria is an obvious exception, with one index case caught quickly).
