While the death toll of the Ebola outbreak has risen to 932, two white American health workers have been treated with an experimental serum called ZMapp—which had previously only been tested on monkeys. Why have they received this potential cure as hundreds of Africans die?
It boils down to logistics and precedent, writes Arthur Caplan, director of the medical ethics division head at NYU Langone Medical Center. Today in the Washington Post, Caplan explains how pharmaceutical companies think about untested drugs and how rural West Africa’s poverty denied it access to the experimental treatment. For one, drugs like ZMapp that contain monoclonal antibodies tend to cost “tens of thousands of dollars,” which institutions in the afflicted countries may not be able to afford. They also lack the infrastructure to handle the serum—ZMapp "requires a lot of refrigeration and careful handling, plus close monitoring by experienced doctors and scientists." The Americans, meanwhile, constitute "a small group" in "a carefully controlled setting" that allows the drug's creator, Mapp Pharmaceuticals, to watch closely for any unforeseen adverse consequences.
Moreover, Caplan writes: the Americans—by way of their missionary group, Samaritan's Purse, and the Centers for Disease Control and National Institute of Health—asked Mapp for the drug, and the West Africans apparently didn't. There is simply no existing framework, he says, by which institutions in outbreak countries can contact and negotiate with pharmaceutical providers. His piece ends with a call for the establishment for policies that would facilitate such potentially life-saving communication.