Desperate times call for desperate measures.
Two drugs are currently being used to treat patients with Ebola hemorrhagic fever (Ebola). Both are relatively untested, meaning they are a long way from being formally approved by the FDA. But when the choice is between watching patients die or trying something, it seems that trying something wins out.
The use of untested drugs and/or drugs in very short supply raises all kinds of ethical issues, of course. The first drug, called ZMapp, had never been tried on humans before now. It was first used on the two Americans who contracted the disease in Liberia and who have since been flown to Atlanta. Aside from the issue of risk to the two patients, there’s the troubling ethical question of favoritism; why was it given to the two Americans first, and not to any of the many African patients? (On the other hand, had it been given first to Africans, there would be complaints that Africans were being used as guinea pigs. You can’t win this one!).
The second drug, called TKM-Ebola, was already in the human testing phase when the Ebola epidemic began. But the tests, which were being conducted on normal human volunteers, had been halted temporarily because of side effects in one volunteer. Given the current situation, though, the FDA took the unprecedented step of approving TKM-Ebola for Ebola patients anyway. Apparently the FDA felt that the potential benefits to patients who actually had Ebola far outweighed the risks.
It takes time to ramp up the production of any drug. Both drugs will be in short supply in the near future, which means that choosing which patients will get them will remain an issue for a while. From a medical point of view, it’ll be interesting to see how effective they actually are.
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