Ebola May Soon Be ‘Preventable & Curable’
Successes in the clinical trials of two new Ebola treatments have resulted in health officials in the Democratic Republic of Congo announcing that all people who contract the virus will now be offered the drugs, which have seen mortality rates in those treated drop significantly - as low as 6% when treated early.
The trial to test four new Ebola treatment drugs in four villages in the DRC was initiated in November 2018. Of the four drugs tested, two proved so successful that they will be the only two drugs that future patients will be treated with.
The Pamoja Tulinde Maisha, or PALM study, is part of an international multi-organisational emergency response to the current outbreak and includes both African and Western governmental organisations and non-profit initiatives coordinated by the World Health Organisation (WHO). In Swahili, the trial name means "Together Saves Lives".
Jean-Jacques Muyembe is the director of Congo’s National Institute for Biomedical Research and has been on the frontlines of Ebola research for the past 15 years. The Institute has also partnered on the PALM trials. Muyembe told the BBC that 90% of people can be cured, with the symptoms often disappearing just one hour after the drugs are administered.
“Now we can say that 90% can come out of treatment cured," he said, adding that despite initial public apprehension about the roll-out of the drug trials, he now believes the results will speak for themselves. "They will start believing it and developing trust. The first ones to transmit this information will be the patients themselves.”
According to the World Health Organisation (WHO) Ebola, a hemorrhagic fever that affects humans and primates, has a fatality rate of around 50%, with some past outbreaks resulting in the death of 90% of people who contracted the disease.
The current outbreak in the DRC was declared on August 1, 2018, and has since resulted in more than 2 800 infections. Of those, 1 900 people have died. It is the second most severe of the ten outbreaks in the country since the discovery of the disease in 1976.
Of those who had low levels of the virus and received the two treatments, known as REGN-EB3 and mAb114, soon after infection, the survival rates skyrocketed to 94% and 89% respectively. The DRC outbreak is the first time that a vaccine has been used as a full-scale weapon against the Ebola virus, and it seems to be paying off.
According to the director of the US's National Institute of Allergy and Infectious Disease, Anthony Fauci, these are the "first drugs that, in a scientifically sound study, have clearly shown a significant diminution in mortality" for Ebola patients.
Michael J. Ryan, who is the executive director for the WHO Health Emergencies Programme has weighed in to remind people that the drug is not yet considered a prevention for Ebola, and that the fight is not yet over. “What will stop Ebola is good surveillance, good infection prevention and control, good community engagement, excellent vaccination and the use of these therapeutics in the most effective way possible,'' he said during a teleconference with the media.
The REGN-EB3 is an antibody formula developed by Regeneron and mAb114 is a monoclonal antibody developed by Ridgeback Biotherapeutics. The drugs were developed using antibodies of Ebola survivors and target the virus, neutralising its impact on the human cell.
The other two formulas in the trial, ZMapp and Remdesivir, have since been dropped as they prove less effective in treating the virus.
Concerns, however, remain with the WHO Emergency Committee on whether there will be enough drugs to be circulated through the affected regions.
Pharmaceutical companies have indicated that there around 500 000 doses available, with at least 1.5 million more that have been manufactured and are ready for deployment. The affected region has a population of around 10 million people.
The vaccine is currently only available for health workers and people who are believed to have contracted the virus. The proposed strategy, however, will aim to distribute the new shipment of drugs outside the outbreak zone in the hope of creating a protective barrier to stop further spread.
Conflict and the presence of armed militia groups in the eastern parts of the DRC are among factors that hindered emergency outbreak interventions, coupled with limited available healthcare resources.
According to a study in the Lancet Medical Journal, the “belief in misinformation" surrounding Ebola "was widespread” and considered one of the biggest obstacles in overcoming the outbreak and combating the virus, as many were reluctant to seek treatment or turned to other interventions to aid them. Local communities also regard foreign medical assistance with suspicion.
August marks one year since the outbreak was declared - the ninth of its kind to hit the DRC over the past 40 years. The current outbreak is the second biggest outbreak recorded in the country, which has seen over 25 000 cases reported between 2014 and 2016, resulting in an estimated 11 000 deaths.