Ebola outbreak may open door to finding drugs that work

Five experimental medicines poised to begin clinical trials in Africa

As another outbreak of Ebola claims lives in Central Africa, researchers are seeing within it a rare ray of hope: a chance to find a cure.

For the first time, five experimental medicines are poised to undergo a real-life clinical trial against the virus at makeshift treatment centers in remote areas of the Democratic Republic of Congo, where most of the 53 new cases originated. The country’s Health Ministry cleared all the treatments for use as of Monday.

Hundreds of vials of drugs in development by Gilead Sciences Inc., Regeneron Pharmaceuticals Inc. and others are on their way or in place. Some have been tested only on animals and a few healthy volunteers, and none has been proved to work against the severe viral disease in a standard clinical test. Now, scientists are seeking a way to offer compassionate treatment for patients with few options while doing painstaking data collection to evaluate the drugs.

Health officials have already begun using an experimental vaccine, donated by U.S. drugmaker Merck, in hopes it will protect people who may have been exposed to infection. The efforts could yield the first weapons against a disease that has no cure and kills about half of the people it infects. At least 25 deaths have been confirmed from this outbreak.

“There’s a consensus that we really need to move forward,” said Vasee Moorthy, an infectious diseases doctor at the World Health Organization who coordinated vaccine research during the last Ebola epidemic. “We hope that by the end of this outbreak we gradually have more information about which drugs provide benefits to patients.”

The obstacles are steep. Normally, researchers test an individual drug against a placebo, but they’d forgo it in this case for ethical reasons. They must also devise a way to randomly assign patients to various treatment groups while taking into account individual medical needs and watching for side effects.

Carrying out a trial that pits multiple untested medicines against one another would be challenging in the best of conditions. This one would take place in an impoverished, equatorial nation of 78 million that’s home to the river that gave Ebola its name and much of the world’s secondlargest tropical forest.

Drugs will need to be shipped by riverboat, on unpaved roads or by helicopter to overcome a lack of infrastructure inland. Some must be kept cold in the hot, humid climate.

“This is no simple piece of work,” Peter Salama, WHO deputy director-general of emergency preparedness and response, said at a briefing in Geneva last week.