Ebola and the failure of Big Pharma

In a damning indictment of a profit-driven industry, the head of the World Health Organisation has denounced the reluctance of the global pharmaceutical corporations to invest in research on Ebola simply because the disease has been confined to poor African nations.  Shila Kaur reports.

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ON 8 August 2014, the Director-General of the World Health Organisation (WHO) Margaret Chan declared the current Ebola outbreak in West Africa 'a public health emergency of international concern'.  'This is the largest, most severe, most complex outbreak in the nearly four-decade history of the disease,' she stated emphatically.

The original outbreak in the West African states of Guinea, Liberia and Sierra Leone spread quickly to Nigeria.  According to WHO estimates, as of 4 August 2014, the number of cases in these four countries stood at 1,711, including 931 deaths. 

But a 24 September Bloomberg news report stated that since its appearance in Guinea in December 2013, Ebola had spread very quickly to five West African countries, infecting 5,864 people and killing 2,811. The Bloomberg article attributed the figures to WHO's 22 September report and went on to state that it was an underestimate. The report added that the US Centers for Disease Control and Prevention (CDC)'s worst-case scenario pointed to 'significant under-reporting' of cases by a factor of 2.5. With the correction, the CDC predicted that there would be 21,000 total cases in Liberia and Sierra Leone alone by 30 September.

What is undeniable is that, in a continent that is on course to improving living conditions and the health status of its inhabitants, Ebola has set back hard-won political stability and economic recovery and is reversing recent gains in health outcomes.

This latest outbreak has trained the spotlight on two critical issues, viz., the state of health systems in the affected countries and the absence of a vaccine for Ebola.

At a meeting of WHO's Regional Committee for Africa in Benin on 3 November, Chan pointed out that when heads of state in non-affected countries talked about Ebola, they blamed the outbreak on 'failure to put basic public health infrastructures in place'.

'Without fundamental public health infrastructures in place, no country is stable.  No society is secure.  No resilience exists to withstand the shocks that our 21st century societies are delivering with ever greater frequency and force, whether from a changing climate or a runaway killer virus,' she stated.

It is clear that a lack of fundamental health infrastructure is indeed the root cause for the spread of what Keiji Fukuda, WHO Assistant Director-General for Health Security, calls 'not a mysterious disease, but an infectious disease that can be contained'.

Writing along similar lines in The Independent on Sunday on 3 August, Professor John Ashton, the President of the UK Faculty of Public Health, stressed: 'The real spotlight needs to be on the poverty and environmental squalor in which epidemics thrive, and the failure of political leadership and public health systems to respond effectively.  The international community has to be shamed into real commitment . if the root causes of diseases like Ebola are to be addressed.'

The problem with Big Pharma

On the problem of the absence of a vaccine, there can be little question as to who is to blame. At the Benin meeting, WHO's Chan took the bull by the horns and blamed Big Pharma for causing the problem. She lambasted the pharmaceutical industry for neglecting to create a vaccine for the Ebola virus despite its having exacted a human toll in Africa for almost 40 years.

In a damning statement, Chan said, 'Because Ebola has historically been confined to poor African nations, the R&D [research and development] incentive is virtually non-existent. A profit-driven industry does not invest in products for markets that cannot pay. WHO has been trying to make this issue visible for ages. Now people can see for themselves.'

Chan's views find resonance in Ashton's earlier article. Ashton branded the unwillingness of Big Pharma to invest in research on treatments and vaccines a 'scandal'. Big Pharma refuses to invest in this type of research 'because the numbers involved are, in their terms, so small and don't justify the investment.  This is the moral bankruptcy of capitalism acting in the absence of a moral and social framework.'

In his article, Ashton also lamented the 'failure to mobilise an adequately resourced international medical response' to the Ebola outbreak. In contrast to what he called the 'tardiness' of the international response, it is heartening to note that Cuba, a small island nation with few financial resources, pledged 461 doctors and nurses to provide care in Guinea, Liberia and Sierra Leone.  Medecins Sans Frontieres (MSF) or Doctors Without Borders, the international medical humanitarian organisation, deployed 270 international healthcare specialists working in the affected countries.

Meanwhile more than 90 of the world's leading scientists have participated in a joint collaborative effort on an experimental Ebola vaccine, from national and university research institutions to government health agencies, ministries of health and foreign affairs, national security councils and several offices of prime ministers and presidents. Anthony Fauci, Director of the US National Institutes of Health and one of the world's leading immunologists, told the BBC in August that he hoped to develop a vaccine by the middle to end of 2015.                   

Shila Kaur is Health Consultant with the Third World Network.

*Third World Resurgence No. 290/291, October/November 2014, pp 22-23