Liberia announced Monday that it would soon receive doses of an experimental Ebola drug and give it to two sick doctors, making them the first Africans to receive some of the scarce treatment in a spiralling outbreak.
The U.S. government confirmed that it had put Liberian officials in touch with the maker of ZMapp, and referred additional questions to Mapp Biopharmaceutical Inc. In a statement, the California-based company said that in responding to a request from an unidentified West African country, it had run out of its supply of the treatment.
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The news comes as anger is growing over the fact that the only people to receive the experimental treatment so far have been Westerners: two Americans and a Spaniard, all of whom were evacuated to their home countries from Liberia.
Late Monday, the World Health Organization said 1,013 people had died in the Ebola outbreak in West Africa. Authorities have recorded 1,848 suspected, probable or confirmed cases of the disease, the UN health agency said. The updated WHO tally includes figures from Aug. 7-9 when 52 more people died and 69 more were infected.
There is no Ebola vaccine or treatment available, but there are several in development besides ZMapp. That treatment is so new that it hasn't been tested for safety or effectiveness in humans. And the company has said it would take months to produce even modest quantities.
It was unclear how much of the treatment would be sent to Liberia.
"The U.S. Government assisted in connecting the Government of Liberia with the manufacturer," the U.S. Department of Health and Human Services said in a statement. "Since the drug was shipped for use outside the U.S., appropriate export procedures had to be followed."
2 Americans, Spaniard received drug
The Liberian statement, posted on the presidency's website, said it was also receiving an experimental treatment from the World Health Organization. It was unclear if this was also referring to ZMapp or another treatment.
In the past few weeks, the experimental drug was given to two American aid workers diagnosed with the disease while working at a hospital that treated Ebola patients. On Monday, officials in Spain disclosed that the treatment would be given to a Spanish missionary priest who fell ill while working in Liberia, but he has since died. The Madrid hospital on Tuesday would not confirm that he had been treated with the drug, but his order said earlier he would be.
The Americans are said to be improving, but there's no way to know whether the drug helped, or if they are getting better on their own, as others have. Around 40 per cent of those infected with Ebola are surviving the current outbreak.
But some called for the untested drug to be given to Africans, too. The outbreak was first identified in March in Guinea, but it likely started months earlier. It has since spread to neighbouring Liberia and Sierra Leone, and possibly to Nigeria.
"There's no reason to try this medicine on sick white people and to ignore blacks," said Marcel Guilavogui, a pharmacist in Conakry, Guinea. "We understand that it's a drug that's being tested for the first time and could have negative side effects. But we have to try it in blacks too."
Some are using Twitter to demand that the drug be made available.
"We can't afford to be passive while many more die," said Aisha Dabo, a Senegalese-Gambian journalist who was tweeting using the hashtag "GiveUsTheSerum"on Monday. "That's why we raise our voice for the world to hear us."
'Compassionate use' exemptions
The ethical dilemmas involved prompted the UN health agency to consult Monday with ethicists, infectious disease experts, patient representatives and the Doctors Without Borders group. Most participants in the closed teleconference were from developed countries, but Uganda and Senegal were represented. The World Health Organization said it would discuss the results of the meeting at a press conference on Tuesday.
Companies can provide experimental drugs on a "compassionate use" basis, usually after they have been fully tested in humans. The Food and Drug Administration approves such uses in the U.S., but has no authority overseas. Ultimately, the companies alone decide whether or not to share their products.
Spain's Health Ministry said it obtained ZMapp this weekend with company permission to treat Miguel Pajares, a 75-year-old priest evacuated from Liberia and placed in isolation Thursday at Madrid's Carlos III Hospital.
"The medicine was imported from Geneva where there was one dose available in the context of an accord between the laboratory that developed the medicine, WHO and [Doctors Without Borders]," the ministry said, invoking a Spanish law permitting unauthorized medication for patients with life-threatening illnesses.
Spanish authorities refused to comment beyond the ministry's statement, but Geneva University Hospital told The Associated Press it was involved in getting the drug to Madrid.
The evacuated American aid workers, Dr. Kent Brantly and Nancy Writebol, have been improving at Atlanta's Emory University Hospital. They got the treatment after their international relief group Samaritan's Purse asked Kentucky BioProcessing, which produces it for Mapp Biopharmaceutical.
Guinea hoping to be next
The treatment is aimed at boosting the immune system's efforts to fight off Ebola. It is made from antibodies grown inside tobacco plants
A Sierra Leone official said they had not asked for the drug, but the other governments said they want any treatment that might help patients recover, despite the risks of unproven medicines.
"The alternative for not testing this is death, a certain death," Liberia's information minister, Lewis Brown, told The AP in an interview before the announcement.
Guinea said Monday it wants some, too.
"Guinean authorities would naturally be interested in having this medicine," said Alhoussein Makanera Kake, spokesman for the government committee fighting Ebola.
Ebola is spread through direct contact with the blood or bodily fluids of a sick person. It begins with symptoms including fever and sore throat and can escalate to vomiting, diarrhea and internal and external bleeding.
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