Global Trends by Martin Khor

Monday, 18 August 2014

Alarm bells over ebola outbreak

Ebola is a deadly disease, with no approved cure.  This raises various issues, and urgent steps must be taken to contain and fight it.  


The ebola outbreak in several West African countries is causing concern all over the world.  That is easy to understand.  Ebola is a deadly disease, more than half of those contracting it can die, there is so far no cure and it seems to be quite easily passed on from one person to another.

Almost 2,000 people are known to have been infected and more than a thousand have died, and even this is probably a significant under-estimate.

In the most affected countries, medical facilities are over-stretched, and supplies of personal protective equipment and disinfectants are inadequate and a crisis atmosphere has developed.

Also alarming is that many doctors, other medical personnel and social workers who have been helping the victims have themselves come down with the disease.

According to one report, over 170 health related workers have been infected and some have died, including the leading doctor fighting the disease in Sierra Leone, and a Spanish priest running a facility providing assistance to patients.

This news prompts us to really appreciate those medical and social workers who are prepared to take risks to live up to the best ideals of their noble professions.

We know that there are those who are dedicated to work with the poor, the sick and down-trodden.  But to give treatment and comfort to those who are probably terminally ill, while knowingly taking high risk to their own health and lives, is really admirable.

How many of us are willing to take such risks? 

Another example of selfless dedication in the face of danger is the team of Malaysian doctors and other health personnel who left for Gaza last week to provide help to the Palestinian victims of the air, land and sea attacks by the Israeli military forces.

They join the small group of dedicated local and foreign health personnel who have been working round the clock during the weeks of aerial bombing and artillery shelling which also targeted some hospitals, besides houses and schools, during the bombardment of Gaza.

Although there is a temporary ceasefire, there is no certainty this will continue, and Gaza may come under fire again, at any time.  The Malaysian volunteer team is therefore facing serious danger.  After all, there is no “safe area” in Gaza if the fighting resumes, not even a hospital or a United Nations school.   

The absence of a proven cure makes ebola an almost hopeless disease for a person to have.

There is a medicine for treating ebola, Zmapp, developed by an American firm, but it has not yet obtained approval for safety and efficacy by the drug regulatory authority.

An ethics committee of the World Health Organisation last week ruled that ebola patients can be given this treatment although there is yet no safety approval.

In the assessment of cost and benefit, the cost of having possible side effects is countered by the possible cure for such a disease with a high possibility of death.

It is reported that two American doctors who had been flown back to the US after being infected had responded positively to the drug.

Another problem is that there are very few doses of the Zmapp medicine available, even if affected countries are willing to use it.

It is likely that there will be a rush to obtain the very limited supply of the medicine.

Hopefully, in the midst of the crisis, the question of the cost of the medicine will not be an impediment.  Lives are at stake and the medicine concerned is at an experimental stage and not yet approved.

However, the issues of high cost, patents and access to medicines can be expected to arise.  If the drug is finally approved, and a patent granted, the company could charge a rather high price, and other companies could be prevented from producing other versions of the medicine.

During the avian flu outbreak in Asian countries a few years ago,   the Indonesian health authorities were upset when a global drug company offered to supply vaccines at a high price.

It turned out that the vaccines had been made with the content of influenza virus samples that Indonesia had freely supplied through a WHO influenza scheme.

Companies who had received the virus samples had gone ahead to patent the genetic materials of these samples, thus enabling them to also claim exclusive rights to the vaccines, and thus to charge high prices and block others from producing them.

After an uproar, an agreement was reached in the WHO that in return for countries supplying the samples of the influenza viruses, the companies which undertake research on the viruses should not patent the viruses and would have to contribute funds to the WHO for running the scheme.

Ebola has emerged as the latest threat to health, starting with West Africa, but which may spread to other regions.

Measures must be taken in all countries to prevent the entry of this disease, to stop its spread if it does enter, and to get access to medicines to treat it.

It is early days yet of the current ebola crisis, and the situation will get worse before it gets better.  It is thus best to face up urgently to this emergency.