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Opting Against Ebola Drug for Ill African Doctor
By ANDREW POLLACKAUG. 12, 2014
The doctor who had been leading Sierra Leone?s battle against the Ebola outbreak was now fighting for his own life, and his international colleagues faced a fateful decision: whether to give him a drug that had never before been tested on people.
...
The treatment team, from Doctors Without Borders and the World Health Organization, agonized through the night and ultimately decided not to try the drug. The doctor, Sheik Umar Khan, died a few days later, on July 29.
The doses of the drug that were not used were eventually sent to Liberia, where other doctors made the opposite decision ? and two American aid workers became the first people in the world to receive ZMapp. Both of them survived and are now being treated at Emory University Hospital in Atlanta.
?It?s a little political; that?s what it looks like to me,? Alhajie Khan, Dr. Khan?s brother, said of the decision. ?Why would you not give it to him? The guy who helped all of these people.?
...
The previously untold story of Dr. Khan, recounted by two doctors involved in discussions about whether to use ZMapp, offered an unusual glimpse into the wrenching ethical dilemma of when and how experimental drugs should be used to combat the Ebola epidemic in West Africa. Had the treatment team decided differently in his case, the first person treated with the drug would have been African.
...
In the case of Dr. Khan, who has been called ?the arrowhead of the fight? against Ebola in his country, the doctors involved said there was no intention to save the drug for Americans. They said it was not known that the American aid workers were sick at the time of the decision not to treat Dr. Khan, around July 23. Instead, they said, doctors feared stoking the considerable suspicion of Western medical institutions in the country, which was already making it harder to contain the outbreak.
...
?What they really didn?t want to do was kill Dr. Khan with their attempt at therapy,? said Dr. Armand Sprecher, a public health specialist at Doctors Without Borders. ?If word got out that M.S.F. killed Dr. Khan, that would have implications for outbreak control,? he added, using the initials for the French name of the relief group.
Dr. Sprecher, who is involved in the procurement and use of drugs for Doctors Without Borders but was not directly treating Dr. Khan, said another factor was that Dr. Khan?s virus levels were so high it was believed the drug would probably not work.
He said the treatment team never discussed the option of using the drug with Dr. Khan himself, deciding it would do so only if it decided to go ahead with the treatment.
...
http://www.nytimes.com/2014/08/13/w...atedCoverage®ion=Marginalia&pgtype=article
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Doctors: Ebola drug poses 'impossible dilemma'
Published August 13, 2014?
Associated Press
Doctors treating a Sierra Leone physician with Ebola defended their decision not to give him an experimental drug, saying Wednesday they feared it was too risky.
Calling it "an impossible dilemma," Doctors Without Borders explained in detail their decision in response to a New York Times story on the case. It would have been the first time the experimental drug was tried in humans.
The explanation came the same day that another top doctor from Sierra Leone died of the disease, further fueling a debate about how to apportion a limited supply of untested drugs and vaccines and whether they are even effective.
At the time the experimental treatment was being considered for Dr. Sheik Humarr Khan, his immune system was already starting to produce antibodies suggesting he might recover, Doctors Without Borders said in the statement. Khan was also due to be transferred to a European hospital that would be more capable of handling problems that might arise, it said.
The experimental drug, ZMapp, is designed to boost the immune system to help it fight the virus. Since Khan's body was already producing an immune response, the doctors may have feared that any boost would kick it into overdrive.
In the end, the treating physicians decided against using the drug. They never told Khan of its existence because they felt it would be unethical to tell him of a treatment they might not use. Shortly after their decision, however, Khan's condition worsened, the statement said, and the company providing the medical evacuation decided not to transfer him. He died a few days later, on July 29.
More...
http://www.foxnews.com/health/2014/08/13/doctors-ebola-drug-poses-impossible-dilemma/
By ANDREW POLLACKAUG. 12, 2014
The doctor who had been leading Sierra Leone?s battle against the Ebola outbreak was now fighting for his own life, and his international colleagues faced a fateful decision: whether to give him a drug that had never before been tested on people.
...
The treatment team, from Doctors Without Borders and the World Health Organization, agonized through the night and ultimately decided not to try the drug. The doctor, Sheik Umar Khan, died a few days later, on July 29.
The doses of the drug that were not used were eventually sent to Liberia, where other doctors made the opposite decision ? and two American aid workers became the first people in the world to receive ZMapp. Both of them survived and are now being treated at Emory University Hospital in Atlanta.
?It?s a little political; that?s what it looks like to me,? Alhajie Khan, Dr. Khan?s brother, said of the decision. ?Why would you not give it to him? The guy who helped all of these people.?
...
The previously untold story of Dr. Khan, recounted by two doctors involved in discussions about whether to use ZMapp, offered an unusual glimpse into the wrenching ethical dilemma of when and how experimental drugs should be used to combat the Ebola epidemic in West Africa. Had the treatment team decided differently in his case, the first person treated with the drug would have been African.
...
In the case of Dr. Khan, who has been called ?the arrowhead of the fight? against Ebola in his country, the doctors involved said there was no intention to save the drug for Americans. They said it was not known that the American aid workers were sick at the time of the decision not to treat Dr. Khan, around July 23. Instead, they said, doctors feared stoking the considerable suspicion of Western medical institutions in the country, which was already making it harder to contain the outbreak.
...
?What they really didn?t want to do was kill Dr. Khan with their attempt at therapy,? said Dr. Armand Sprecher, a public health specialist at Doctors Without Borders. ?If word got out that M.S.F. killed Dr. Khan, that would have implications for outbreak control,? he added, using the initials for the French name of the relief group.
Dr. Sprecher, who is involved in the procurement and use of drugs for Doctors Without Borders but was not directly treating Dr. Khan, said another factor was that Dr. Khan?s virus levels were so high it was believed the drug would probably not work.
He said the treatment team never discussed the option of using the drug with Dr. Khan himself, deciding it would do so only if it decided to go ahead with the treatment.
...
http://www.nytimes.com/2014/08/13/w...atedCoverage®ion=Marginalia&pgtype=article
------------------------------------------------------------------------------------------------------------------------
Doctors: Ebola drug poses 'impossible dilemma'
Published August 13, 2014?
Associated Press
Doctors treating a Sierra Leone physician with Ebola defended their decision not to give him an experimental drug, saying Wednesday they feared it was too risky.
Calling it "an impossible dilemma," Doctors Without Borders explained in detail their decision in response to a New York Times story on the case. It would have been the first time the experimental drug was tried in humans.
The explanation came the same day that another top doctor from Sierra Leone died of the disease, further fueling a debate about how to apportion a limited supply of untested drugs and vaccines and whether they are even effective.
At the time the experimental treatment was being considered for Dr. Sheik Humarr Khan, his immune system was already starting to produce antibodies suggesting he might recover, Doctors Without Borders said in the statement. Khan was also due to be transferred to a European hospital that would be more capable of handling problems that might arise, it said.
The experimental drug, ZMapp, is designed to boost the immune system to help it fight the virus. Since Khan's body was already producing an immune response, the doctors may have feared that any boost would kick it into overdrive.
In the end, the treating physicians decided against using the drug. They never told Khan of its existence because they felt it would be unethical to tell him of a treatment they might not use. Shortly after their decision, however, Khan's condition worsened, the statement said, and the company providing the medical evacuation decided not to transfer him. He died a few days later, on July 29.
More...
http://www.foxnews.com/health/2014/08/13/doctors-ebola-drug-poses-impossible-dilemma/