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Ebola Ethics

Professor Adrian Hill holds a vial containing an experimental Ebola vaccine. Dr. Hill is the Director of the Jenner Institute and Chief Investigator of the trials at the Oxford Vaccine Group Centre for Clinical Vaccinology and Tropical Medicine (CCVTM) in Oxford, England September 17, 2014. REUTERS/Steve Parsons/Pool, September 2014

Sporadically emerging from its natural reservoirs, the Ebola virus has recently captured global attention. Looming over West Africa, the Ebola pandemic has been transmitted and transported over national boundaries, now finding itself on U.S. soil. But the Ebola virus is not new; this disease was first noted in Zaire, the predecessor of the Democratic Republic of the Congo, in 1976. Since then, these outbreaks have occurred with certain regularity. Yet, there has been no effort since then to develop a cure for the Ebola virus. Instead, the standard line of treatment remains managing the symptoms of this harrowing illness. This cavalier attitude by the United States government and America’s leading pharmaceutical agencies to such a potentially destructive disease seems to point at a larger problem in the modern capital-driven pharmaceutical system.

According to the CDC, during an outbreak in 1995 in Kikwit, Democratic Republic of Congo, 173 contacts of 27 primary Ebola cases resulted in a 17% transmission rate. Although Ebola is highly virulent, ranging from 50 to 70% depending on the various viral strains, the transmissibility of the virus seems to range on the lower end of the spectrum. Transmission requires direct contact with bodily fluids of an infected person, and due to this fact, the likeliness of Ebola becoming a global pandemic seems to be low. This remains a standard answer to why pharmaceutical corporations have not invested in an Ebola cure. But on the other hand, Kalydeco, a drug that treats a minor form of Cystic Fibrosis which was developed by Vertex, only targets about 3,000 people worldwide. This drug was introduced into the market close to 300,000 USD a year. Cystic fibrosis is a genetic disease that has no likelihood of transmission and no substantial effect on public safety. In other words, large pharmaceutical corporations like Johnson & Johnson, Pfizer, and GlaxoSmithKline (which has recently started to make 10,000 doses of Ebola vaccines for human testing) are moved largely by prospective profit. This may seem obvious enough, but the tremendously disturbing implications of such a system remain a large problem for the medical community. According to the MIT Technological Review, the FDA approved 39 NCE’s or new chemical entities in 2012, but “most of the new drugs either treated rare diseases like cystic fibrosis or were marginal improvements over existing cancer drugs. All carry[ing] extremely high price tags.”  The ethical implications of developing treatments targeting the diseases of the wealthy leads to a chronic misrepresentation of pharmaceutical needs. As a result, pharmaceutical companies largely ignore diseases with most destructive potential to public safety until the disease has reached a critical mass.

The extensive coverage of the Ebola outbreaks in West Africa could potentially heighten he increased visibility of various NTD’s as explained by Julia Kollewe at the Guardian. Neglected Tropical Diseases affect more than 1 billion people in the poorest regions of the world, and yet, according to the British Medical Journal, many of the treatments involve toxic drugs that are difficult to administer, some which “are more than 50 years old.” Chagas disease, lymphatic filariasis, and trypanosomiasis contribute to a systemic subjugation of the world’s poorest people. People are unable to work for income because of the rampant effects of disease; patients are unable to find proper medical treatment and access to modern drugs because the modern pharmaceutical system neglects those that do not have money.

Governments and corporations must begin to realize the implications of an increasingly globalized world. Diseases endemic to another country can in an instant find itself a new home in America. Even from an economic standpoint, it is prudent to invest in health safety measures that decrease the spread of disease in other countries. The current mentality is flawed; just because a disease is “not in my backyard” does not mean there are no global ramifications if the problem is left unchecked.