Via The Lancet: Ebola in west Africa. Excerpt:
Until recently, the task of managing the outbreak has been left largely to national governments and non-governmental organisations such as Médecins Sans Frontières. A surge in cases since June, the first case in Nigeria in July, and the illness of the two Americans have now triggered a more proactive response from the international community.
WHO sent a team of experts at the end of June and has issued a call for infection-control professionals to work in affected countries. The US Centers for Disease Control and Prevention has disease control experts in all four countries and intends to deploy an additional 50 staff within the next month. The World Bank has pledged up to US$200 million in emergency funding to affected countries.
The two American health workers were given the experimental treatment ZMapp (dubbed “secret serum” in some reports, although it's neither secret nor a serum) before evacuation from Liberia. This development raises ethical issues around use of experimental drugs and equity of access to treatment.
Because Ebola is a potential agent of biological warfare, the US Government has funded development of ZMapp, which is a mixture of three humanised monoclonal antibodies against the Ebola virus produced in tobacco plants. The drug was effective in a monkey model of Ebola, but has not entered human trials. The US Food and Drug Administration has given approval for another government-funded drug, TKM-Ebola, which interferes with viral RNA, to be used in Ebola-infected patients.
On Aug 12, a panel convened by WHO concluded that, in the circumstances of the Ebola outbreak, use of unproven treatments is ethical. This seems a laudable conclusion when death is the most likely outcome of infection. In reality, current supplies of ZMapp are exhausted after the donation to Liberia of enough drug to treat just two patients.
The international community is only now catching up with the rapid spread and scale of the Ebola outbreak. The epidemic reinforces the need for nations to investment in health infrastructure and disease surveillance to keep pace with other developments in Africa. Efforts to contain Ebola should not divert resources from more mundane infections, such as malaria, which have a far higher long-term disease burden.