I almost worked on Ebola virus. A PhD candidate at Emory University, I had the option of working at the Centers for Disease Control and Prevention. After reading The Hot Zone and a lecture on emerging diseases from one of its heroes, C.J. Peters, I was ready to don bio-hazard gear for a P4 lab.
I never did, because my advisers told me it wasn’t a good idea. (Mom didn’t love the idea, either.) Research on emerging diseases is tough, and not just because of exposure to the pathogens. While labs in some CDC divisions can poke at the same pathogens for years, the emerging disease labs may have to switch to the latest virus to break into the human population. In the late ’90s, it wasn’t clear whether Ebola or Marburg, another filovirus, would be the bigger problem. After 9/11, the Bush administration shifted some of the CDC’s focus to potential bioterrorism weapons.
All that was at stake for me was the speed and quality of my PhD research, and I couldn’t be sold on Ebola research. So I can’t imagine convincing investors to put money behind a cure for a virus that had only affected 1,700 people (Wikipedia) since its discovery in 1976. In many ways, Ebola was like an orphan disease, where research can be a lose/lose proposition. If the disease stays rare, there aren’t enough cases to turn a profit. If it becomes epidemic, public outcry for cheap availability may kill your margin. Often, such research is left to government entities and foundations.
When word leaked that two Americans had received an experimental Ebola treatment, I was frankly glad to hear anyone had gotten that far. So I was surprised by the immediate vitriol aimed at Mapp Biopharmaceuticals, a San Diego company, for offering the drugs to Americans first.
I understand how it looks – white people from rich countries get treated while people of color from impoverished countries die. There are clearly situations with proven therapies, like HIV medications, where those aren’t just the optics, they are the reality, and we need to do much better.
ZMapp, the Ebola drug, isn’t one of those cases. It hadn’t been tried in humans, and they had a limited supply. Scaling up production from mice to humans is not simple – you can run months of animal experiments on the dose needed for humans. Not that you know what the human dose is, because you haven’t gotten there yet. And plenty of mouse medical miracles have been toxic in humans. Had they offered ZMapp to African countries earlier, and it made things worse, the same people would have wondered, correctly, why they were using poor people of color for experimentation.
By the current information, Mapp played by the rules. Unless that changes, we should be proud that a potential treatment for a deadly disease is coming from San Diego. Now that the World Health Organization has approved the use of experimental drugs for Ebola, Mapp may be able to help more people, if they can rev up the tobacco plants that grow the drug.
