Deep in the grips of an Ebola outbreak, the Democratic Republic of the Congo has embarked on an "important step" toward finding an effective treatment for the deadly virus. The World Health Organization said the country has launched the first-ever multidrug clinical trial for potential Ebola treatments.
"The giant step DRC is taking now will bring clarity about what works best, and save many lives in years to come," Tedros Adhanom Ghebreyesus, the WHO's director-general, said in a statement released Monday. "We hope to one day say that the death and suffering from Ebola is behind us."
The trial aims to determine which of the four leading Ebola treatments — referred to by the WHO as mAb114, Regeneron, Remdesivir and ZMapp — proves most successful in combating a virus that can have a high fatality rate.
Since the latest outbreak was declared about four months ago, the Democratic Republic of the Congo health ministry says there have been at least 419 confirmed and suspected cases of Ebola — at least 240 of whom have died.
2. The #Ebola case counts now stand at 419 confirmed & probable cases & 240 deaths. This outbreak is on the verge of becoming the 2nd largest ever; currently in #2 spot is the Gulu (Uganda) outbreak of 2000, which had 425 cases & 224 deaths. pic.twitter.com/KYOsrRGTfN
— Helen Branswell (@HelenBranswell) November 26, 2018
To better evaluate these drugs, the WHO has revised a treatment protocol it created specifically for Ebola, known as Monitored Emergency Use of Unregistered and Investigational Interventions. The organization came up with the protocol as an emergency workaround, intending to enable medical workers to use experimental treatments that had not yet passed clinical trials.
"The new medicines that we're using, they're not approved for Ebola because there's not enough clinical trials to show they're effective," the WHO's Janet Diaz told NPR's All Things Considered earlier this month. "So what we got was permission from the ethical committee of the Congo to use these potentially lifesaving therapeutics in patients in the DRC."
The WHO explains that this protocol will remain the same, but for one big change.
"Patients will not be treated noticeably differently from before, though the treatment they receive will be decided by random allocation," the group explained. "The data gathered will become standardized and will be useful for drawing conclusions about the safety and efficacy of the drugs."
In fighting the most recent outbreak, however, medical workers have had more to contend with than the disease alone. The Ebola cases surfaced in Democratic Republic of the Congo's war-torn eastern provinces, North Kivu and Ituri, where rebels are waging a bloody guerrilla campaign against government forces.
Seven United Nations peacekeepers were killed in one such skirmish earlier this month, and another 11 civilians — including two Congolese health workers — were killed in the region last month. Experts fear that continued bloodshed is impeding the medical response and could derail it altogether. In addition to tracking and treating cases, frontline health workers are vaccinating tens of thousands of people.
"You take that away, you've removed a dampener," J. Stephen Morrison, director of the Global Health Policy Center, told NPR's Nurith Aizenman. "You're going to see a sharp escalation of this outbreak. And your risks of export into the region and beyond go through the ceiling."
It is already the Democratic Republic of the Congo's largest Ebola outbreak ever on record. Still, the country's health minister, Oly Ilunga, expressed hope Monday that the new randomized trials mark a turning point on how to treat the virus.
"Our country is struck with Ebola outbreaks too often, which also means we have unique expertise in combating it," he said. "These trials will contribute to building that knowledge, while we continue to respond on every front to bring the current outbreak to an end."
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