DN Editorial: A DOSE OF REALITY

WHY WOULD the United States decline to provide a serum that can cure Ebola to poor and desperate victims in several African nations where close to 1,000 people have died of the virus? Because it doesn't have such a serum.

What the U.S. does have are a number of possible treatments for Ebola that are in the experimental stages. Most were developed with the help of federal financing after 9/11; drug companies previously had little financial incentive to develop drugs for an illness that affected relatively few people, all of them in developing countries. But after the 2001 attacks, the government became interested in staving off possible bioterrorism.

Some of the treatments look very promising after early trials on animals. But it is not yet known whether any will cure or prevent the illness in humans, or even whether they are safe for humans to take. Nor is it known which among them would prove the most helpful.

As it happens, the experimental treatment that two American aid workers were given after being stricken with Ebola in Liberia was ZMapp, a cocktail of three monoclonal antibodies. Both patients are improving, an outcome that has governments in the affected African countries as well as three highly regarded Ebola experts clamoring to have the serum released to the hundreds of people who are infected.

That would be premature. The Americans may have been lucky, or they may have benefited from their access to far better medical care than most Africans get, or perhaps they can thank their own robust immune systems, a result of growing up with adequate food, clean water and other benefits of the developed world.

To many Africans, it looks as though rules were bent on behalf of a couple of white Americans, while the hundreds of infected people in Africa are receiving no special treatment. Isn't an experimental treatment better than nothing?

Perhaps the answer would be different if this epidemic carried the 90 percent mortality rate that Ebola has sometimes inflicted in the past. But that's not the case with this epidemic.

This is a decision that has to be made carefully and rationally, although without delay. There are other promising Ebola treatments that are in Phase I safety trials; ZMapp hasn't reached that stage yet. Without random, controlled clinical trials, the United States or the World Health Organization might commit too early to the widespread use of a less useful treatment, or one that is far more expensive and thus would not reach as many people.

At the same time, it is our moral responsibility to look for ways to speed reasonably safe medications to those who need them. The U.S. Food and Drug Administration should approve expedited safety trials that take a month or so, instead of the six months that full Phase I trials require. It would take at least that long anyway for pharmaceutical companies to ramp up production to cover affected populations.

Even with pharmaceutical treatment, it would take a massive public health and education effort to bring the West Africa epidemic to a close any time soon, and at that point there will be time for fuller testing. But if anything, this epidemic teaches us that when it comes to developing lifesaving pharmaceuticals, we don't always have as much time as we think.