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Though Profit is Major Obstacle to Ebola Vaccine, Human Trials are Coming

Though Profit is Major Obstacle to Ebola Vaccine, Human Trials are Coming

As of August 5, 2014, the World Health Organization is reporting more than 1,700 confirmed or suspected cases of Ebola in four different countries, including 932 deaths. It is the deadliest Ebola outbreak since the virus was first identified in 1976. The countries with the highest number of cases suffer from extreme poverty and a virtually non-existent health care system. The fatality rate is high because it generally strikes those already with poor health exacerbated by living conditions and lack of adequate health care. The arrival of two stricken American doctors in the United States represents the first time the virus has been within our borders.

All of this has raised the specter of the virus in the United States as well as interest as to why, after nearly 40 years, there hasn’t been an antidote or a vaccine.

It’s not because scientists don’t know about the virus. Since it was first discovered, the Ebola virus has changed very little. Scientists know that the virus is zootonic, meaning it is transferred from animals to humans. There are five subspecies of the virus, with four of them having caused disease in humans. Those four viruses originated in fruit bats native in Africa, which is where all Ebola outbreaks have occurred to date.

The virus can only be spread through direct contact with the bodily fluids of an infected person.  Because it can stay alive on surfaces for several days, it can be spread by touching surfaces where an infected person has been. The virulent side effects of the virus, including vomiting and diarrhea, can make containment difficult in the poor sanitary conditions of the affected areas. Health care workers lack the resources to keep themselves and others protected. The sheer volume of patients has stretched limited resources to the breaking point. Exhausted and overwhelmed, they do what they can to support patients, often to their own detriment.

In short, the virus is limited to a small population in mostly remote, poor areas in Africa. Until now outbreaks have affected only a few hundred people at most. This is why containment has worked because it has been easy to isolate the population.

These factors are also why there hasn’t been a vaccine.

Scientists have been working on a vaccine for more than a decade. There are currently several preventive therapies at various stages of development. Thus far, they have been very successful in nonhuman primate test subjects.  The vaccines have been developed by small companies and there are possibly five that are ready for human test subjects.

All they need is money.

Big pharmaceutical companies have little interest in spending research and development dollars on something that will bring them little money. The affected people are poor and there would be little chance to extract a large profit for a drug that would be limited to one geographic area. Human test trials are expensive and any money would have to come from governments. Nations with research funds outside of Africa are also similarly disinclined to spend money on something that, quite frankly, just doesn’t affect them.

Preventing the death of poor people in Africa is not a profitable business model.

There are some practical considerations, however. While it would make sense to inoculate health workers as a preventive measure, it would be difficult to access the populations that are most at risk of contracting the virus. The remote locations, limited health care infrastructure and fear of outside medicine are the greatest impediments to mass inoculation. Vaccines have a limited shelf life, so mass production would not be prudent and it’s not possible to produce them on demand.

The United States Department of Defense and the National Institute of Health (NIH) have provided the most government funding for the research so far. The interest is not altruistic. The focus has been to understand the virus and development of antidote or vaccine in the event the Ebola virus was to be used for biological warfare.

Recently, two American doctors who contracted the virus while working in Liberia were treated with an experimental therapy. Both of them responded well to the treatment due to the medical care they are now receiving in Atlanta. While the controversial treatment has raised hopes for a possible solution, including financial investment into the company that developed it, there is still reason to remain cautious.  The two doctors were healthy when infected, now have access to excellent medical care and are white.

They are not the typical Ebola patients and their response cannot be expected to translate to the general affected population.

The high number of health care workers being infected with the Ebola virus, coupled with the high rate of international travel, has caused concern about the spread of the virus to the west.  Post infection therapies would still be difficult to administer for the same reasons that a vaccine would be. Furthermore, due to the rapid nature of how the virus replicates, it would have to be administered quickly after contracting – something not easily done in remote areas. Most believe that focus on an easy to administer, long acting vaccine would be the best approach.

Late Wednesday, the FDA issued an emergency fast track approval for Phase I human trials for the most advanced Ebola vaccine. The approval will allow clinical trials to begin as early as September. The experimental vaccine was developed by a research arm of the NIH called the Vaccine Research Center. Even with the fast tracking, the earliest a vaccine would be available would be late 2015 and that is only if all goes well during the trials. Still, this is much quicker than the average 10 years it takes to get most new vaccines to market.

People will not be infected with the virus during the trials. If the vaccine is proven to be safe and effective, healthcare workers would be the first to receive the vaccine. The NIH is working with other researchers that are close to human clinical trials and will be seeking approval for those to move forward as well.

 

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Photo: Ebola virus via Thinkstock

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70 comments

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6:34PM PDT on Aug 18, 2014

Sorry, that was meant to be "don't waste any more time, these poor people need help now."

6:32PM PDT on Aug 18, 2014

For pity's sake, someone provide the necessary money! There is so much money in the world, please give some to this very worthy cause! This should have been done long ago, don't waste any more time helping these poor people.

6:14PM PDT on Aug 18, 2014

Phil M stated: "Well, I can sense all the conspiracy theorists coming out of the woodwork already."

No kidding! The Conspiracy Theorist Fear Factor forces are amassing as we read.

Nina L lamented: "In the "Extinction Protocol" you can read about it. ...And remember there is a de-population program running ... and it is easier to "kill" people through illness than through guns.

An 'extinction protocol,' not to mention a 'depopulation program.' Where, Jurassic Park?
Tell me, when the alleged wiping out of much of the world populace supposedly occurs, how are the rich going to get their shoes shined? Heaven forbid that they would have to do these things for themselves, let alone repair their own cars and grow their own crops...getting their paws dirty and the things that they usually assign their minions (aka the rest of humanity) to carry out at their behest. They will all have nightmares just thinking of that one, they will actually have to work like the rest of humanity that they are supposedly wiping out.

Mark D, one can always count on you for delivering the daily Ray of Sunshine Weather Forecast for the future of humanity complete with your usual thundering showers of eternal optimism.

4:15PM PDT on Aug 17, 2014

Maybe this is just Nature's way of dealing with human overpopulation destroying the earth. Once Ebola becomes airborne watch out.

6:32AM PDT on Aug 11, 2014

I had to stop reading the comments, or I was going to vomit. What an utterly idiotic article, designed to produce moral outrage in ignorant fools, and many of you stepped up to the plate. You should be ashamed of yourselves.

Why in the world should anyone have invested hundreds of millions of dollars in finding a vaccine for a disease that killed a few hundred people per decade in remote places in Africa? If you're going to spend that kind of money, Africans would tell you to direct it elsewhere - like plumbing, the lack of which makes diseases like this thrive. This sort of 'journalism' is no different, and no better, than those idiots over at Fox frightening conservatives about ebola threats from refugee children on the border, despite the fact that we have only those two imported cases in Atlanta in the entire Western Hemisphere. Good grief. Carole P, who I often loathe, made the only intelligent comment on this thread. 'Concern' trolls are no better than gun trolls or abortion trolls, and most of you have behaved trollishly.

4:16AM PDT on Aug 11, 2014

ty

3:52AM PDT on Aug 11, 2014

" Preventing the death of poor people in Africa is not a profitable buisness model" Is this what we have come too?

12:41PM PDT on Aug 10, 2014

noted

9:12AM PDT on Aug 10, 2014

It's always because of profits that the world is going to a dead end. I never understood why rich people are interested in getting more money. What the hell would they use it for if not for important issues as this one? It is simply unacceptable that poor people are always excluded by these cases.

3:34PM PDT on Aug 9, 2014

On the late news last night it said that a woman who had flown in from Nigeria had been admitted to hospital with symptoms of ebola. How many people did she infect on her travels?
Just goes to show you that it can cross from one continent to another and create another outbreak far away from where it is now..

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