On Tuesday, a World Health Organisation (WHO) panel of medical experts ruled that it is ethical to offer untested drugs or vaccines to those people either infected or at risk due to the current Ebola outbreak. The panel however has cautioned West African officials that supplies will be limited.
WHO Approves Untested Drugs
A statement released by the WHO indicated that the panel has disclosed that any provision of experimental Ebola medicines would require “informed consent, freedom of choice, confidentiality, respect for the person, preservation of dignity and involvement of the community,” adding that the drugs should be properly tested in the best possible clinical trials. The ethics panel met last week in order to discuss whether various experimental drugs and vaccines being developed to fight Ebola may be used in the current outbreak despite not having been fully tested or licensed. The meeting was called after the experimental Ebola drug ZMapp, which is produced by US biotech company Mapp Biopharmaceuticals, was given to two American health workers who were infected with Ebola while working in Liberia.
On Wednesday, Canadian officials disclosed that between 800 and 1,000 doses of an experimental Ebola vaccine, which has so far only been tested on animals, will be donated to the WHO for use in West Africa. Canada however will keep a small portion of the vaccine for further research and in the event that an Ebola case appears in the country.
However while Canada has announced that it will send doses of the experimental vaccine to the WHO, experts are warning that it will likely take between four and six months in order to make a large enough quantity to have any real impact at preventing the illness. Officials at the WHO have disclosed that so-called “first in man” trials, which are the first tests of the drug to be carried out on humans, will likely be conducted over the next two to four months. However even if the trials of the drug prove to be successful, supplies of it will remain limited, noting “it is…likely that the number of doses available for further study and/or deployment from end 2014 onwards will remain insufficient to meet demand.”
New WHO Figures Released
New data released by the WHO on Monday indicated that the death toll in the Ebola outbreak in West Africa has now passed 1,000, and that the outbreak does not appears to be slowing down. In a press release Monday, the United Nations health agency confirmed that 1,013 people have died in the outbreak with authorities recording 1,848 suspected, probable or confirmed cases of the disease. The updated WHO figures are from August 7 – 9, when 52 people died and 69 more were infected. During this period, Guinea reported six additional deaths and 11 new infections; Liberia had 29 more deaths and 45 cases while Sierra Leone saw 17 new fatalities and 13 new cases.
In total, Guinea has reported 506 cases, with 373 deaths; Liberia has 599 cases, with 323 deaths; Sierra Leone has reported 730 cases and 315 deaths while Nigeria has thirteen cases and two deaths.
The World Heath Organization (WHO) on Thursday called for “drastic action” in order to fight the deadliest Ebola outbreak on record, and announced an 11-nation meeting to address the growing crisis.
As of Sunday 22 June, 635 cases of hemorrhagic fever, most confirmed to be Ebola, including 399 deaths, have been reported across Guinea, Liberia and Sierra Leone. This effectively makes the outbreak the largest ever “in terms of the number of cases and deaths as well as geographical spread.” A statement released by the UN agency stressed that “drastic action is needed,” and warned of the danger that the virus could jump to other countries. The WHO’s call for drastic action comes just days after medical charity Doctors Without Borders (MSF) indicated that the virus was now “out of control.’
Since the deadly epidemic emerged in Guinea in January, WHO has deployed more than 150 experts in a bid to tackle the crisis. However despite its efforts, and the efforts of other medical charities, over the past three weeks there has been a “significant increase” in the number of cases and deaths reported each day. According to WHO’s regional director for Africa, Dr Luis Sambo, the agency is now “gravely concerned by the on-going cross-border transmission into neighboring countries as well as the potential for further international spread,” adding “this is no longer a country specific outbreak but a sub-regional crisis that requires firm action by governments and partners.”
WHO’s top Ebola specials Pierre Formenty warned last week that the recent surge in cases had likely come in part because efforts to contain the virus had been relaxed too quickly after the outbreak appeared to have slowed down in April. In order to address the on going crisis, officials at the WHO announced Thursday that they will convene a meeting of the health ministers from 11 countries in Accra, Ghana on July 2 – 3 in order “to discuss the best way of tackling the crisis collectively as well as develop a comprehensive inter-country operation response plan.” Ministers from Guinea, where nearly 400 confirmed, suspected and probably cases have surfaced so far, including 280 deaths; and Liberia, which has 63 cases and 41 deaths, will take part in the meeting. Ministers from Sierra Leone will also be present. Additionally, neighboring countries, including Gambia, Ghana, Guinea Bissau, Ivory Coast, Mali and Senegal, and countries as far afield as the Democratic Republic of Congo and Uganda have also been invited. The meeting will also include a range of UN agencies and other aid organizations including MSF and the Red Cross as well as the Western African, British, EU and US centers for disease control.
Meanwhile on Wednesday, officials from the WHO announced that, at the request of the Sierra Leonean government, they were changing the way it reports fatalities from the Ebola outbreak in the country.
Previously, probable and suspected deaths from Ebola were included in the count however from now on, only laboratory confirmed cases will be reported. Therefore this reduces the death toll in Sierra Leone from 58 to 34 as of 24 June 2014. According to WHO spokeswoman Fadel Chaib, the way that deaths are reported in Guinea and Liberia, which are the other two countries affected by the deadly outbreak, will remain unchanged.
The change comes after Sierra Leone’s press had criticized the government for reporting lower death rates than those reported by the WHO. The changes however now bring the WHO figures inline with those released by the Sierra Leone government. The latest Ebola outbreak has now been named by international organizations as the worst Ebola epidemic ever with 635 cases and 399 fatalities occurring in dozens of sites across the three countries, including in major cities and remote areas. Officials from Doctors Without Borders (MSF) have described the outbreak as “out of control,” adding that it had reports of cases in more than 60 sites and that its resources were now stretched to the limit. In light of the on going outbreak, which has worsened in recent weeks, the European Commission announced Tuesday that it was committing an additional 500,000 euros in funding in order to combat the outbreak. This latest funding brings its total contribution to 1.9 million euros.
The first cases of the Ebola virus have been confirmed in Liberia, after spreading from neighboring Guinea, where the deadly virus has already killed eighty-four people. Meanwhile in Mali, officials are on high alert after three suspected cases were reported near the border area with Guinea.
Fears Virus Has Spread to Mali
Officials in Mali on Thursday indicated that they had detected three suspected victims of the Ebola virus, the deadly disease that has killed 84 people in Guinea. Speaking to reporters in Bamako, Mali’s Health Minister Ousmane Kone stated that “three suspected cases of hemorrhagic fever have been detected in the country. Samples have been taken and sent abroad for analysis.” The Health Minister added that pending results from the US Centers for Disease Control and Prevention, where the samples were sent, the patients were isolated and were receiving appropriate medication. A statement issued by the government has indicated that the patients’ condition was currently improving and that the results of the tests will be made public as soon as they are known.
Ebola Outbreak Confirmed in Liberia
Seven new patients has brought the total suspected Ebola cases in Liberia to fourteen. Since reporting its first case of the hemorrhagic fever last month, six people have died, however officials in Liberia indicated Thursday that the first suspected Ebola case is now thought to be unconnected to the ongoing epidemic in neighboring Guinea, noting that the case may have originated separately within its borders.
According to Liberia’s chief medical officer Bernice Dahn, “we have a case in Tapeta where a hunter who has not had any contact with anyone coming from Guinea got sick,” adding “he was rushed to the hospital and died 30 minutes later. He never had any interaction with someone suspected to be a carrier of the virus and he has never gone to Guinea. This is an isolated case.” If confirmed, the case in the eastern town of Tapeta would mark a worrying development in the fight against Ebola, as cases so far have been attributed to people returning with the infection from neighboring Guinea, where 84 people have died. Tapeta, a small town in the eastern country of Nimba, is located 400 kilometers (250 miles) from the epicenter of the Ebola outbreak in southern Guinea. It is also at least a five-hour drive and much further from the border than other suspected cases.
Of the six deaths, two were laboratory-confirmed Ebola cases – a woman who died in hospital in the northern county of Lofa and her sister who visited her. The sister was allowed to return home to Monrovia before being hospitalized in the nearby Firestone Hospital. Local authorities had isolated her and were monitoring her, her family and others with whom she may have had contact however Mr Dahn has since indicated that “…after being confirmed Ebola virus positive, the lady died this morning.” He added that “we are now keeping surveillance on 44 people who have been in contact with the cases reported.” The fruit bat, which is thought to be the host of the highly contagious Ebola virus, is a delicacy in the region that straddles Guinea, Liberia and Sierra Leone, with experts suspecting huntsmen to be the source of the outbreak.
The outbreak in Guinea had initially centered in the country’s remote south-eastern Forest Region of Nzerekore, where it took officials six weeks to identify the disease, effectively allowing it to spread over the borders and into the more populous regions of the country. The first symptoms experienced were of a feverish sickness and they were observed on February 9. The mysterious disease claimed at least 23 lives, out of a total of 36, before officials were able to identify it. Since then, the outbreak has continued to spread, with officials confirming last week that it had spread to the capital, Conakry, which is a sprawling city of two million.
On Sunday, Guinea’s Health Ministry indicated that the country was now dealing with 122 “suspicious cases” of viral hemorrhagic fever, including at least 80 deaths. However not all of the cases have been confirmed as the Ebola virus. Medical Charity Medecins Sans Frontieres (MSF) has since stated that the Ebola outbreak in Guinea is “unprecedented,” adding that the spread of the disease across the country made it very difficult to control. Guinea is now facing a battle to contain the outbreak after cases were reported in areas that are hundreds of kilometers apart.
Over the past weekend, there has been a growing concern that the outbreak of the deadly virus may spread throughout West Africa. According to Tarik Jasarevic, spokesman for the WHO, up to 400 people are identified as potential Ebola contacts in Guinea, Sierra Leone and Liberia.
Fears of the virus spreading further into West Africa prompted officials in Senegal to close the country’s normally busy border with Guinea. Senegal’s Health Minister Awa Maria Coll-Seck confirmed Monday that the government had decided to close its border with Guinea after receiving confirmation that the virus had reached the country’s capital city Conakry. According to Ms Coll-Seck, Senegal has also “…closed all weekly markets, known as luma, in the south. And we’re having some discussions with religious leaders regarding big religious events.”
Officials in Sierra Leone also reported last week some suspected cases of the Ebola virus however these have not yet been confirmed.
The Ebola virus, which is one of the world’s most virulent diseases, was first discovered in the Democratic Republic of Congo (DRC) in 1976. The DRC has since had eight outbreaks of the disease, with the most recent epidemic, which occurred in the DRC between May and November 2012, infecting 62 people and leaving 34 dead. Although there have been previous outbreaks amongst humans in Uganda, the Republic of Congo and Gabon, the disease had never before been detected in people in West Africa. There have also been fears that the disease could one day be used in a biological weapons attack as, according to researches, the virus multiplies quickly, overwhelming the immune system’s ability to fight the infection.
If all cases in Guinea, Sierra Leone, Mali and Liberia are confirmed to be Ebola, this outbreak would be the most deadly epidemic since 187 people died in Luebo, in the Congo’s Kasai Orientale province in 2007.
According to the World Health Organization (WHO), to date, no treatment or vaccine is available for Ebola, which kills between 25 and 90 percent of those who fall sick, depending on the strain of the virus. The Zaire strain of Ebola, which has a 90 percent death rate, is the one that has been detected in Guinea.
Yesterday, October 7th, two people were killed in a terrorist attack on a polio vaccination campaign in the troubled frontier city of Peshawar in Pakistan. Despite being one of the few nations in the world were polio remains endemic, attacks on vaccination workers are not uncommon. Rumours and distrust of the vaccines are spread by fundamentalist clerics in the country, and large swathes of the country remain unvaccinated despite the authorities’ desire to eradicate the disease and amidst continuing warnings from the World Health Organisation. Recent weeks have seen numerous serious terrorist attacks in Pakistan, raising fears of further destabilisation surrounding the nation’s already acute security challenges. In particular, further moves to attack aid organisations and ethnic minority groups are particularly concerning.
The blast happened outside a health clinic in Sulemankhen, on the outskirts of Peshawar, yesterday. Two people were killed, one a police officer and the other a local member of a ‘volunteer peace committee’. 20 people, mainly members of the police, were also injured in the attack. A second, larger, device was found at the scene and diffused. Monday was the third and final day of a campaign aiming to vaccinate 10’000 children through Khyber Pakhtunkhwa province, and the bomb was detonated remotely when police gathered to protect the vaccination teams.
A faction of the Pakistani Taliban, Jundullah, has claimed responsibility for the attack, releasing a statement saying “Jews and the United States want to stamp out Islamic beliefs through these drops”. Jundullah is a prolific terrorist organisation, and has been connected with numerous attacks throughout Pakistan in recent months, including the murder of climbers in Gilget-Baltistan in June and last month’s attack on the Christian community in Peshawar.
Vaccination campaigns have come under attack in Pakistan before. Earlier this year, also in Peshawar, two female aid workers were shot dead, while another 8 vaccination workers were murdered in December last year. The use by the CIA of a fake hepatitis vaccination program to gather intelligence about the whereabouts of Osama Bin Laden in 2011 has reportedly damaged the reputation of aid and vaccination programs in Pakistan. However, issues with vaccinations have been fermenting for several years outside of this, with Islamist propaganda in Pakistan often claiming vaccination programs are attempts by the West to sterilise Muslim populations, or that the vaccines are ‘un-Islamic’ as they supposedly contain pork derivatives. This phenomenon has manifested in other countries with similar strains of Islamist militancy such as Nigeria, which saw the murder of nine vaccination workers earlier this year.
Largely seen as an anachronism in the West, polio remains endemic in only three countries worldwide – Nigeria, Afghanistan and Pakistan. Amidst increasing rates of the disease in Pakistan and the warnings of international health organisations, the Pakistani authorities have launched campaigns in attempts to eradicate the disease in recent years, but have faced widespread resistance in the fractious and restive border and tribal areas.
This recent attack comes amidst a spate of serious attacks throughout the country in recent weeks that have killed over 150 people. Despite the government of Prime Minister Nawaz Sharif making overtures to militants late in August, the security situation in Pakistan appears to be becoming increasing unstable, with the country’s regular terrorist attacks showing no sign of abating. The Pakistani authorities have been criticised in the past for the lack of a coherent or robust national security strategy, and with elements of the Pakistani state widely seen as collaborating with some terrorist movements, serious doubts remain about their ability to contain the violence. Currently, all the indications are that the security situation in Pakistan is only likely to deteriorate further in the foreseeable future.
A particularly concerning trend is a diversification of the victims targeted in terrorist attacks, as opposed to the traditional targets of Shia Muslims or the Pakistani security forces. Recent months have seen the murder of foreign mountaineers at the base of Nanga Parbat, attacks on Pakistan’s tiny Christian minority and yesterday’s targeting of an UN-backed health campaign. As such, the security risks for foreigners in Pakistan remain severe and are only set to increase if, as seems likely, this trend continues.