Bioethics Blogs

Ebola: An Emergency within an Emergency

Alison Thompson suggests that the Ebola outbreak is part of a larger emergency defined by a lack of public health infrastructure.

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Amid the worst Ebola outbreak ever, the World Health Organization (WHO) has declared that it can be ethical to offer experimental pharmaceutical interventions. Normally, experimental drugs and vaccines are first tested on healthy volunteers. But, in the case of Ebola, a public health crisis of international significance, this is a luxury we don’t have time for.

Two American aid workers who contracted Ebola were recently treated with an experimental drug called ZMapp. And following the WHO’s declaration regarding experimental Ebola drugs and vaccinations, Canada has pledged to donate up to 1000 doses of the experimental Ebola vaccine called VSV-EBOV. Neither ZMapp nor VSV-EBOV has been tested on humans.

"Kenema Hospital Sierra Leone Ebola" by Leasmhar

“Kenema Hospital Sierra Leone Ebola” by Leasmhar

The allocations of these scarce, potentially useful experimental drugs should be done in a way that restores trust. This is particularly true in the case of experimental vaccines because of the history of vaccine boycotts in West Africa stemming from deep mistrust of Western intervention. There is strong suspicion, especially in Northern Nigeria, that vaccines are the vehicle for the West to sterilize or infect Africans with the HIV virus. So, introducing an experimental vaccine in this region that could cause harm is a very risky proposition and it could have far-reaching consequences for the efforts to control polio and other infectious diseases. Whether or not the usual prescription for trust-building, such as being transparent, listening to communities about their concerns and being responsive to them will be enough to allow people to place their trust in outsiders again remains to be seen.  Trust can’t be rebuilt in a day, especially in the midst of a crisis.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.