Spread of Ebola Continues as WHO Agrees to the Use of Untested Drugs

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.

Iraqi Parliament Selects New Prime Minister

On 11 August, Prime Minister Nouri al-Maliki was effectively deposed. Early in the day, the Iraqi National Alliance, a coalition of mostly Shi’a political parties, nominated deputy parliament speaker Dr. Hadier al-Abadi to become the new Prime minister. Shortly after newly elected President Fouad Massoum asked officially gave al-Abdadi his first responsibility as prime minister: to form a new government within the next 30 days. Nouri al-Maliki has declared that he will fight the decision, stating that Abadi’s nomination has no legitimacy. He called the move “dangerous violation” of the constitution, and vowed to “fix this mistake.” Under the Iraqi constitution, the president must appoint the chosen nominee of the largest parliamentary bloc. Al-Abadi comes from the same political party as Maliki. Immediately prior to the decision, Maliki had ordered his elite army units into the streets of Baghdad in a show of force. However, a senior government official said commanders of military forces that Maliki deployed around Baghdad had pledged loyalty to President Fouad Masoum, and agreed to to respect his decision to ask Abadi to form a new government. On 12 August, a statement appeared on Maliki’s official website ordering security forces not intervene in the conflict over who will be the next prime minister. Rather, they should remain focused on defending the country. Maliki has been widely derided for implementing pro-Shi’a sectarian regulations that have widely disenfranchised and alienated Sunni Muslims in Iraq during his eight-year tenure. It is believed that his sectarian policies spurred the actions of ISIS, the terrorist organisation that has taken over vast swaths of Iraqi land and Syria in recent months. Despite Maliki’s claims that the ouster was illegitimate, Iraqi media channels have already widely welcomed al-Abdadi, with some pro-Sunni stations criticising his refusal to step-down for the sake of the nation. Beyond Iraq, the appointment of al-Abadi has been met with welcome by many among the international community. Jordanian media has issued congratulations to the new Prime Minister. EU foreign policy Chief Catherine Ashton called Abadi’s appointment a “positive step”. US Secretary of State John Kerry stated that Washington is prepared to “fully support a new and inclusive Iraqi government”, urging Abadi to quickly form a fully functional cabinet: “We are prepared to consider additional political, economic and security options as Iraq’s government starts to build a new government.” In Iran, a nation that was once considered an ally by al-Maliki, the decision to remove him from office has been regarded as a positive one. Ali Shamkhani, secretary of Iran’s Supreme National Security Council, has offered his congratulations to al-Abadi and the Iraqi people. Shamkhani is a close ally of Iranian President Rouhani, and a representative of Ayatollah Ali Khamenei. The Iranian recognition of Abadi appears to eliminate Maliki’s main avenue of support of regaining power. Iran perceives ISIS as a threat to their national security. The Iranian government believes that in order to quell the spread of the terror group, Iraq must have a unity government, which Maliki has openly opposed. Abadi, a British-educated electrical engineer in his mid 60s, also served as an intermediary between diplomats and Western journalists in Iraq. He was exiled to England during the reign of Saddam Hussein when the Dawa party which he represented was banned from the country. He is perceived as a considerably more moderate and unifying figure than his predecessor. In order to prove his ability to form a unity government, he must reintroduce Sunni and Kurdish officials into senior positions in the Iraqi government and military. Under Maliki’s regime, all senior positions were held by Shi’a officials. He has little time to not only implement a unity government, but to also raise morale in the nation, as Sunni Muslims and other denominations will want to see immediate change, and the Kurds are pushing ever harder for an autonomous state. As one writer put it, the threat to Iraq is “existential, not political.”

CAR Appoints New Prime Minister as Clashes Continue

On Sunday, just days after the Central African Republic’s interim government resigned, the country’s president, Catherine Samba Panza, named her new prime minister. The mainly Muslim rebel Seleka group however has rejected the appointment of the CAR’s first Muslim prime minister, stating that it wants no part of the new government.

Mahamat Kamoun was appointed prime minister Sunday evening, effectively replacing Andre Nzapayeke, who stepped down last week. Mr. Kamoun, an expert in finance, was the director general of the treasury under former president Francois Bozize. He later became a special advisor to the current interim president. While he has now been tasked with leading a transitional government that is seeking to implement a precarious ceasefire signed late last month, officials within the Seleka rebel group have rejected the decision, stating Monday that while Mr Kamoun had served as head of the tax-collecting agency, he was not a Seleka member. Abou Mal Mal Hissene, a Seleka spokesman, disclosed Monday that the group’s leaders “…think the transitional president didn’t take account of the views of the Seleka, which still controls the majority part of the country,” adding “the Seleka will not participate in the government.” The spokesman also reported that the fragmented collation of former rebels had learned of the appointment of a new prime minister “by way of foreign media.” Despite refusing to join the new government, the spokesman did note that the Seleka leaders remain committed to the peace accord, which was signed in Brazzaville last month.

On Tuesday, President Samba Panza confirmed that the government had resigned as part of a peace deal that was reached last month with the Christian and Muslim rebel factions. The resignation of the interim government, which includes Prime Minister Andre Nzapayeke along with twenty other ministers, will make way for a new one that is more inclusive.

Mr. Kamoun, who is the first Muslim to serve as prime minister in the CAR since the country gained its independence from France in 1960, will now face the difficult task of revitalising a delicate political transition that is aimed at ending deadly sectarian violence and disarming militias. Despite the appointment and the promise of a more inclusive government, many hurdles remain on the CAR’s path to peace. The inclusion of armed groups within the future government remains to be a sensitive topic in on-going discussions. There are however signs that Mr Kamoun’s appointment may aid in reducing tensions.

While Seleka rebels continue to clash with anti-balaka forces, the Seleka coalition itself is weak and fragmented as its members are divided between those who support dialogue and those who refuse to make any concessions and instead call for a partition of the country. This appointment may ease the tensions between the government and former Seleka coalition members, and will likely undercut support for those pushing for a partition. Furthermore, Mr Kamoun’s appointment is likely to reassure the Muslim minority community, many of whom have been treated with suspicion by the country’s Christian population following the Seleka takeover in March 2013. While the interim president’s promises of a more inclusive government appear to be coming true, this has yet had an impact on the current situation throughout the country as tensions on the ground have not eased and the ceasefire signed in Brazzaville remains extremely fragile.

After weeks of relative calm in the capital Bangui, clashes erupted on Friday and Saturday between two rival factions of the anti-balaka militia. International peacekeepers deployed throughout the CAR were forced to intervene. The latest confrontations, which occurred in the Boy-Rabe neighbourhood in northern Bangui, came just two days after dozens of Seleka fighters attacked French peacekeepers who were patrolling the northern town of Batangafo. Two French troops were injured in the clashes.

Bahrain Accuses Qatar of Luring Nationals

The nation of Bahrain has accused neighbouring Qatar of luring Bahraini nationals to take Qatari citizenship. Bahrain called the action harmful to their national security. Bahrain’s Interior Ministry’s Undersecretary for Nationality, Passports and Residence Affairs, Sheikh Rashid bin Khalifa Al-Khalifa, said that “Qatar has targeted specific families and singled out a particular category of people, without any consideration for the provisions of the law on citizenship in Bahrain.” He added that the naturalisation of Bahrainis’ into Qatar could affect Bahrain’s security and vital interests. No information was provided as to who was being targeted by the Qataris, or how many had been granted Qatari citizenship.

The allegation could further deepen the rift among nations in the Gulf Region. Qatar has already been accused by several Arab states of interfering with the internal affairs of other nations. In particular, the accusation is based upon Qatar’s open backing of the Muslim Brotherhood movements throughout the Arab region. In March, Bahrain, Saudi Arabia and the United Arab Emirates recalled their ambassadors from Doha.

Bahrain’s sensitivity in the matter could be related to their desire to protect the nation’s demographic balance. The country is led by a Sunni-ruled monarchy; the population has a Shiite majority. Bahrain has experienced ongoing, sometimes violent conflict between the government and the population since 2011. Citizens of Bahrain continue to call for a democracy which is representative of these sectarian divisions. Further, Bahraini Shi’ites have long accused their government of naturalising Sunnis from abroad in an effort to outnumber the Shiite population.

The Qatari government has not commented on the allegations, however one Qatari source claims that the request actually came from Bahraini families with tribal links to Qatar. He added that the requests were still under advisement.

Bahrain, meanwhile, has revoked the citizenship of nine Bahrainis convicted of convicted on charges including participation in an illegal organisation and having ties to Iran. The defendants received prison terms ranging from seven to 22 years. Al-Wefaq National Islamic Society, the largest Shiite political party in Bahrain, called the convictions “an unacceptable violation of fundamental human rights,” adding that “the authoritarian and unelected regime in Bahrain is misusing power to retaliate against its dissidents.” In 2012, Bahrain stripped the citizenship of 31 prominent activists and opposition leaders, including two al-Wefaq MPs. This is the first instance of nationality being stripped from ordinary citizens. Some believe that this action is being taken as part of the campaign to reduce the Shiite majority.

Liberia Announces State of Emergency as Concern Grows Over Outbreak in Other Countries

As the West African region continues to struggle to contain the outbreak of the deadly Ebola virus, on Wednesday, Liberian President Ellen Johnson Sirleaf declared a state of emergency. The move, which is set to be ratified by Liberia’s parliament on Thursday, comes a week after Sierra Leone’s government declared a state of emergency.

Speaking on national television President Sirleaf disclosed that the state of emergency would come into effect as the epidemic now represented a threat to state security, noting that Liberia required “extraordinary measures for the very survival of our state and for the protection of the lives of our people.” The Liberian President further noted, “ignorance and poverty, as well as entrenched religious and cultural practices, continue to exacerbate the spread of the disease.” A statement released by the presidency has indicated that the state of emergency is effective as of 6 August and will last for a minimum period of ninety days. While the Liberian government has not yet disclosed the full effects of this state of emergency, sources have indicated that some civil liberties may have to be suspended as the country moves to contain the outbreak.

The outbreak of the deadly haemorrhagic fever has overwhelmed healthcare systems across the affected regions while the on going fight against its spread has been largely hampered by the fact that many indigenous people living in the forested border areas that straddle Guinea, Liberia and Sierra Leone believe that the virus was either introduced deliberately or it is a hoax fabricated by the West and designed to subjugate them. Such beliefs have resulted in relatives discharging highly contagious patients and taking them back to their villages, where countless individuals may have come into contact with them.  According to medical sources, “when patients are forcefully taken away, there comes the problem of transmission of the disease to others and this makes the issue of contact-tracing difficult.” Despite Liberian officials announcing that anyone caught hiding Ebola-infected persons would be arrested, many observers continue to indicate that the Ebola crisis in the country has gotten worse because many people are choosing to keep their sick relatives at home instead of taking them to isolation centres. In Guinea, medical experts have been attacked by angry mobs while in Sierra Leone and Liberia, traditional communities have ignored warnings not to touch the bodies of the dead during funeral rituals.

This has also prompted the deployment of troops to quarantine the worst hit areas in the remote border regions of Guinea, Liberia and Sierra Leone.  In Liberia, operation “White Shield” has seen the country’s army deployed to implement controls and to isolate the severely affected communities. On Wednesday, Liberia’s information ministry disclosed that soldiers were being deployed to the isolated, rural counties of Lofa, Bong, Cape Mount and Bomi. Soldiers will set up checkpoints in these areas and will implement tracing measures on those residents who are suspected of coming into contact with Ebola patients. In Sierra Leone, 800 troops, including 50 military nurses, have been deployed to guard hospitals and clinics that are treating Ebola patients.

New WHO Figures Indicate Spread of Ebola Continuing

New data released by the World Health Organization (WHO) has indicated that between 2 – 4 August, forty-five new deaths have been reported, bringing the total to 932 in Guinea, Liberia, Sierra Leone and Nigeria. Most of the fatalities have been reported in Liberia, where 282 people have died of the virus. There have also been 1,711 cases reported. This has prompted WHO experts and officials to meet in Geneva Switzerland this week in order to discuss new measures to contain the outbreak. On Wednesday, officials at the WHO also indicated that they would convene a meeting of medical ethics specialists next week in order to decide whether to approve experimental treatment for Ebola. The decision comes as some leading infectious disease experts have been calling for experimental treatments to be offered more widely in order to treat the disease. According to sources, the two-day meeting will also decide whether it is necessary to declare a global health emergency. If such a public health emergency is declared, this could involve detailed plans to identify, isolate and treat cases as well as to impose travel restrictions on the affected areas.

Further Cases Reported in Nigeria

As the death toll continues to rise, concern has been growing over the spread of Ebola and the threat that it may extend to other countries outside of the African continent. International alarm at the spread of the disease increased late last month after a US citizen died in Nigeria after flying from Liberia. Since then, concern has been growing over the number of new cases that have been reported in Nigeria as reports have emerged that health officials did not immediately quarantine a sick airline passenger who later died of Ebola.

On Wednesday, health officials in Nigeria confirmed a second death from the Ebola virus, adding that five new cases of Ebola have been reported in Lagos, one of the country’s most populous city. Health minister Onyebuch Chukwu, confirmed, “Nigeria has now recorded 7 confirmed cases of Ebola Virus Disease (EVB),” adding that those who died include a Liberian man who brought the disease to Lagos on July 20 and a nurse who treated him. The health minister further noted that “all the Nigerians diagnosed with EVB are primary contacts” of Patrick Sawyer, who worked for Liberia’s finance ministry and who contracted the virus from his sister. Mr Sawyer was transferred to the First Consultants hospital in the upmarket Ikoyi neighbourhood of Lagos. He died on July 25.

While authorities had initially indicated that the risk of any exposure to others was minimal, as Mr Sawyer had been placed into isolation directly after arriving at the airport with symptoms of Ebola, on Tuesday Lagos state health commissioner Jide Idris revealed that the nature of his disease “was not known” the first day and that only after further investigation did officials suspect Ebola.

Tuesday’s announcement that Mr Sawyer had not been immediately quarantined further underscore concerns that West African countries are not adequately equipped in order to contain such a disease. While the Ebola virus can spread only through bodily fluids, and after the patient begins to show symptoms, the incubation period can last up to three weeks. Consequently, some of the Nigerians who treated Mr. Sawyer are only now showing signs of illness.

Possible Ebola Case Outside of African Continent

Saudi Arabia’s health ministry revealed Wednesday that a Saudi man, who was being treated for Ebola-like symptoms, has died at a hospital in Jeddah.

The 40-year-old returned from a business trip in Sierra Leone, one of four countries affected by the outbreak, on Sunday. The health ministry has indicated that the man died of cardiac arrest and that he was being tested for Ebola however the ministry has not confirmed whether the tests had concluded that he had the disease.   If confirmed, this would be the first-Ebola related death to occur outside the on going outbreak in Africa, which has already killed more than 900 people this year.   In April of this year, officials in Saudi Arabia announced that they would not issue visas this year to Muslim pilgrims from Guinea, Liberia and Sierra Leone. The decision was made as a precaution to avoid the spread of the disease during the hajj pilgrimage, which sees massive crowds of people from around the world gather in Mecca.