Before dying of Ebola in a Dallas hospital Wednesday morning Thomas Eric Duncan was being given an experimental drug treatment for that virus, which federal authorities had approved for emergency use just days before.
While Duncan’s death sent the stock of the drug’s manufacturer Chimerix plunging on the news, the jury is still out on whether its antiviral brincidofovir can help other people infected with Ebola, including NBC News freelance cameraman Ashoka Mukpo, who was given the same drug in a Nebraska hospital after arriving there Monday.
And the jury is also still out on whether other drug treatments that have been used on several Ebola patients played a role in their survival.
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While the current Ebola epidemic in West Africa—the largest in the virus’ history—is expected to continue for months in several countries there, it could peter out before potential treatments and vaccines are developed well enough to have any significant impact on this outbreak, much less be determined to be effective in combating the virus at all in humans.
But that’s not stopping several companies and health agencies from rushing to conduct trials on a set of experimental drugs, including the one that was used on Duncan. At least three vaccines are being fast-tracked to testing, and another four potential treatments are on deck as well for possible use.
Although the hope is to get those vaccines and treatments deployed fast enough so that they help people avoid and survive Ebola during this epidemic, researchers also want to be ready with enough proven pharmaceutical weapons to block the next outbreak of the often-deadly virus.
Still, “Right now, there are no vaccines or even approved treatments for Ebola,” noted Daniel Epstein, spokesman for the World Health Organization, which has been on the front line in the fight against the epidemic that has so far killed 3,439 people and infected another 4,000.
And it’s not clear if any of the vaccines and treatments in development will end up being the silver bullet—or bullets—for the virus.
The size of this epidemic—significantly greater than any others since the first Ebola outbreak in Zaire in 1976—and the infection of at least two people outside of Africa for the first time, has underscored for many the need to finally develop approved vaccines and treatment.
That sense of urgency accelerated even more Wednesday as Duncan, the first person ever diagnosed with Ebola in the U.S., died.
Fears that Ebola could spread significantly outside of Africa, has led international and U.S. health officials to authorize speeding up the process for testing a set of potential vaccines and treatments.
Typically, ethical considerations of the need to avoid harming people mandate a prolonged testing process for the creation of new drugs, which can take many years to be approved and come to market.
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But Ebola’s sky-high mortality rate means “the ethical concerns are much more reduced,” Epstein said. The current outbreak has a mortality rate of nearly 50 percent, and past ones have had a rate as high as 90 percent.
In a recent meeting of leading virologists conducted by WHO, “everyone agreed that because of the situation, our common aim is to make vaccines available as soon as possible,” Epstein said. “Initially, to protect front-line workers. Then, in the future, the goal is to have a fully tested product. This is a high priority for us.”
Before this outbreak, Ebola drugs had been a relatively low priority for drug companies, Epstein noted. The number of people infected in each of the prior individual outbreak cases was never higher than 500, and often was much lower.
“I assume now that there is so much interest and so much fear, that if people come out with a vaccine for Ebola there would be a big demand for it,” Epstein said.
And in addition to Chimerix’s brincidofovir, the other three drug treatments that have either already been deployed on a very limited scale in Ebola patients, or are available for deployment, are made by Mapp Biopharmaceuticals, Tekmira Pharmaceuticals and Sarepta Therapeutics.
Huge technical difficulties
While testing will begin soon on the vaccines, getting them out into the field will be no easy feat.
WHO’s Epstein also noted that even if the vaccines produced by GSK and NewLink became available, there is a big logistical hurdle deploying them in Africa.
“The two vaccines both have to be stored at minus-80-degrees Celsius,” Epstein, “So that’s a huge technical difficulty. How are you going to get the equipment out in the field?”
Another issue is the time it takes to produce the drugs on a scale where it can have a significant effect on the spread of the virus.
GSK’s chairman of research and development, Dr. Moncef Slaoui, told CNBC’s “Squawk Box” that the company does not expect to be able to make mass quantities of its vaccine for a year or more.
Chris Garabedian, CEO of Sarepta, for weeks has been telling media outlets that his company has about 100 doses of its potential Ebola treatment ready for use if it’s requested. So far, no one has taken him up on that offer despite testing data supporting both the drug’s safety and efficacy, and despite the company’s talks with public health agencies, he said.
But even if they did use the company’s drug, Sarepta might soon run out of the doses, as Mapp did with its ZMapp treatment, and be left in the position where it would have to ramp up production.
Who will fund the drugs?
“I’ve said publicly that it could take at least a year,” Garabedian told CNBC. “We would need hundreds of millions of dollars and at least a year to produce thousands of courses.”
And Garabedian said the time it would take to produce more quantities would increase if the number of cases of Ebola dramatically grew. The costs of production could also escalate into the billions of dollars.
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Funding for Sarepta’s treatment originally came from the Department of Defense, which was concerned about Ebola being weaponized for use by terrorists. That funding dried up in 2010, when the military decided to continue funding Tekmira’s drug, while also funding another drug by Sarepta that is focused on another fatal virus.
Garabedian said that Ebola vaccine and treatment research should be funded by the government or by extremely wealthy philanthropists.
“This is a public health issue at the end of the day,” he said. “This does not fit into a business model.”
Garabedian also said this outbreak presents a rare opportunity not only to save lives with his company’s drug treatment and those of his competitors, but also to test their respective efficacies in the field.
“Let’s try to figure out if these drugs work,” he said.