In 2002, scientists writing in a leading American medical journal discussed the possibility that the Ebola virus could be used in a biochemical weapon. It would be technically difficult and unlikely to cause mass destruction because those infected quickly die and the virus is not as transmissible as many assume. But, the scientists warned, if it could be done, there would be no protection. No vaccine or drug treatment exists.
They were writing in the
Neglected tropical diseases, of which Ebola is one, become visible in the west only when they appear to threaten it. Ebola has had more attention than many, probably because of the dramatic nature of the disease and the need for full body suits and face masks for those caring for its victims. The names of other such diseases - the parasitic leishmaniasis and lymphatic filariasis, for example - hardly trip off the tongue in
Yet Ebola is not a priority for the not-for-profit Drugs for Neglected Diseases Initiative, which works with the
But in a few research institutes and biotech companies in north America, there is work going on, some of it funded by the American military. The US department of defence
There were protests over the
There are some vaccines in development which look promising. "Many of them have just been tested in mice and guinea pigs, but a few have been tested in non-human primates and worked, protecting them from challenge with the virus," said Professor
But however great the need, rushing the vaccine to an outbreak of Ebola in west
Running a trial in the middle of a disease outbreak is really difficult too, because of the careful explanation that must be given to all those who are vaccinated - and those who are not - who are in a distressing situation. Potential side-effects must be talked through and informed consent given.
But if there are to be vaccines and drugs against Ebola, trials in outbreaks will have to be done. "It would be unethical not to acknowledge that potential new treatments could both save lives and reduce transmission in this and future outbreaks," says Professor
He believes it is essential for those with promising drugs or vaccines to be ready to go. They must have done all the preparatory work, the early testing and safety checks, have got the approval of ethical and regulatory bodies and have local and national governments as well as NGOs on board.
"It is a complex situation, requiring very careful consideration," Farrar says. But ultimately, the only way to find out if drugs and vaccines against Ebola work is to try them out in an epidemic.
A Liberian street vendor wears gloves to prevent infection with the Ebola virus in downtown
Photograph: Ahmed Jallanzo/
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