Ebola Outbreak!!!!! Who Should Get Experimental Drugs?

With hundreds of Africans dying from the outbreak of Ebola, some activists have said it is wrong that extremely scarce supplies of an experimental drug went to two white American aid workers.

But others wonder: What if the first doses of the drug — which had never been used in people and had not even finished the typical animal safety testing — had been given to African patients instead?

“It would have been the front-page screaming headline: ‘Africans used as guinea pigs for American drug company’s medicine,’ ” said Dr. Salim S. Abdool Karim, director of Caprisa, an AIDS research center in South Africa.

A history of controversy about drug testing in Africa is just one of the complexities facing public health authorities as they wrestle with whether and how to bring that drug and possibly other experimental ones to the countries afflicted with Ebola. Who should get such a scarce supply of medicine? Health workers? Children? The newly infected who are not yet as sick?

There are virtually no remaining supplies of the drug, called ZMapp, that was used to treat the two Americans, United States officials say. And even a few months from now, according to various estimates, there may be no more than a few hundred doses.

The World Health Organization, which on Friday declared an international health emergency on Ebola, will convene a meeting of ethicists early next week to discuss this delicate and difficult predicament involving the drugs. The United States government is also forming a group to consider these issues, said Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases.

At least two of the countries affected by the Ebola outbreak, Liberia and Nigeria, have asked for the drug, according to a spokesman for the Centers for Disease Control and Prevention.

A perception in the region of unfairness in distributing the medicine could undermine the already shaky willingness of some Africans to trust the Western relief efforts. Dr. Armand Sprecher, a public health specialist for the aid group Doctors Without Borders, said it was unfortunate that the first doses went to white Americans “because it confirms all the suspicions people have.” But, he said, he did not foresee that perception as undermining the relief effort, adding that if effective drugs were available, it could bolster the effort’s credibility and give people an incentive to seek medical care.

"At the moment, our big problem is finding the patients in a timely way and convincing them to come to the treatment center,” he said. “If you don’t have a carrot to hang out there and bring people in, then you can’t contain it.”