Via Thomson Reuters: MERS, Ebola, bird flu: Science's big missed opportunities. Excerpt:
Anyone who goes down with flu in Europe this winter could be asked to enrol in a randomised clinical trial in which they will either be given a drug, which may or may not work, or standard advice to take bedrest and paracetamol.
Those who agree could be helping the world prepare for the next potentially deadly disease pandemic as well as helping scientists who are now desperate to plug gaps in knowledge left by previous missed opportunities.
Scientists are largely in the dark about how to stop or treat the slew of never-seen-before global health problems of recent years, from the emergence of the deadly MERS virus in Saudi Arabia, to a new killer strain of bird flu in China and an unprecedented Ebola outbreak in West Africa.
They have been unable even to pin down where they came from.
That is because vital studies to analyse transmission routes and test experimental drugs or vaccines have simply not been done during epidemics, disease experts say.
It is a failure of science, they say, that should not be allowed to happen again.
"Research in all of the epidemics we have faced over the past decade has been woeful," said Jeremy Farrar, director of the Wellcome Trust global health foundation and an expert on infectious diseases. "The world is at risk because there are huge gaps in our knowledge base.
"We don't now have a vaccine for SARS if it came back tomorrow; we don't know how to treat MERS; it took us six to nine months before we started clinical trials of vaccines for Ebola and in the meantime almost 12,000 people lost their lives; and during the H1N1 pandemic, the number of people randomised into clinical studies was very close to zero."
Bureaucracy, logistics and lack of forethought are the heart of the problem, according to Trudie Lang, professor of Global Health Research at Oxford University who has been working on ways to lower such barriers.
During the Ebola outbreak that swept through Guinea, Liberia and Sierra Leone, Lang's team, which specialises in planning and operating trials in vulnerable populations in difficult settings, was tasked with setting up a clinical study of a potential Ebola treatment called brincidofovir.
"It normally takes 18 months to set up a trial, and we did it in 16 weeks," she told Reuters. "But the problem was we were still behind the curve."
In the 2009 H1N1 "swine flu" pandemic, when many governments had stockpiled antiviral drugs such as Roche's Tamiflu and GlaxoSmithKline's Relenza and doctors prescribed them, often as a preventative measure without a confirmed diagnosis, no proper randomised clinical trials were conducted to find out for sure whether they helped.
This has left health officials with little or no concrete evidence on which to base treatment decisions when the next pandemic flu strain threatens the world.