In this undated handout photo provided by Medecins Sans Frontieres, Cokie van der Velde, a British sanitation specialist for Doctors Without Borders is seen in head-to-toe protective gear in Guekedou, Guinea. Normally, she spends her days in Yorkshire, tending to her garden and looking after her grandchildren. Van der Velde has worked on two previous Ebola outbreaks _ she gets paid a salary and stipend _ and says she does this kind of work because she believes in justice and equality. She said the need is overwhelming in this outbreak because of the heavy toll Ebola has taken on health workers; many of those sickened and killed have been doctors and nurses. That has sparked fear among many local staffers and led to strikes and resignations. (AP Photo/MSF)The Associated Press
In some ways, the world's fixation on Ebola's deadly spread through West Africa is disproportionate to the actual danger. According to the World Health Organization's latest figures, Ebola has killed more than 1,100 people. Those fatalities, while terrible, are dwarfed by those caused by the AIDS epidemic, which kills millions in sub-Saharan Africa every year. And unlike SARS, Ebola is much less contagious. It spreads through direct contact with bodily fluids. Ebola still plays a bit part on the world stage of global pandemics. The virus's so far marginal danger goes a long way to explaining why there isn't any known cure: Until now, there's been no hugely compelling incentive for research companies to develop one. And yet some – including Canada's Tekmira Pharmaceuticals – have come close.
In this context, the WHO was right to approve the use of experimental Ebola vaccines on infected people. The decision, made by a committee of ethicists, was mitigated by worry that testing new drugs in the midst of an epidemic in Africa would appear abusive. However, there was no hesitation in administering an experimental drug, ZMapp, on two white American aid workers after they were infected. So far, they have survived. If anything, giving the experimental drug to outsiders only, while denying Africans the same opportunity, seems to be the greater unfairness. African countries should be empowered to make informed decisions about experimental vaccines. The WHO has now paved the way.
Experimental treatments must always be based on informed consent. The WHO was right to suggest that experimental vaccines can't just go to those in the greatest need, with the best hopes for recovery. They must also strive to gain the most information possible from the administration of those vaccines, with the aim of perfecting them. Unfortunately, much of the debate around Africans' ability to get experimental vaccines remains hypothetical. The vaccines are in extremely short supply. Tekmira's vaccine proved effective in animals, but hasn't been tested in humans. There's no guarantee that it or any other vaccine will work. The first step in fighting Ebola sidesteps all of this debate: It is to contain it by limiting its spread.