In mid-December a potential cure against Ebola will be tested in the Forest Guinea, in the center of Guéckédou run by Doctors Without Borders. This is a team that will lead this first trial in infected patients since the beginning of the epidemic declared at the end of March 5,674 deaths 15,901 cases primarily in three countries West Africa (Liberia, Sierra Leone and Guinea), as the balance of the World Health Organization on November 26th. This is the first of three tests of therapeutic treatment coordinated by World Health Organization.
In Guéckédou, the team will test the Favipiravir, a drug developed against influenza by the Japanese laboratory Toyama Chemical, a subsidiary of Fujifilm. This test should be extended to two other treatment centers, also located in Forest Guinea, one in Macenta opened by the French Red Cross on November 18th; the other N’Zérékoré, is to welcome its first patients in late November, under the responsibility of the international NGO Alima.
“The main test will be on Sixty adult volunteers that arrived at the center within forty-eight hours after the first symptoms, in order to be effective, it is necessary that the patient is not too ill,” explained Dr. Xavier Anglaret , Research Director Inserm, came to Guinea to coordinate the experiment.
High doses, well above those recommended for treating a severe flu, will be administered as tablets diluted in water at a rate of three times a day during the first days, and then the dosage is reduced. “During the ten days of treatment, blood samples will be taken to monitor hepatic, renal, etc but we will limit the number because these acts pose a risk with the presence of the virus in the blood,” says Dr. Anglaret. Samples will be sent to the laboratory P4 Lyon to study viral load.
Two other experimental treatments will be conducted: one in Monrovia, Liberia, in the DWB center, under the direction of an Oxford University team with an American antiviral drug, brincidopovir, the other in Guinea, in the MSF center Donka in Conakry, with the Medical Institute of Antwerp: they will transfuse blood plasma from the healed healed to those infected. The procedures are highly delicate, “the blood supplies transfusions and risks further infection for many Guineans in treatment centers,” says Fernanda Falero, Spanish anthropologist DWB mission in particular to analyze acceptable experimental conditions.
For these three attempts, it is not intended for a test group at first. There will be no placebo treatment performed for comparison purposes, the “emergency control of Ebola requires us to take unusual measures,” admits Dr. Anglaret.
The preparation of the trial conducted by Inserm has held many meetings in Guéckédou between local DWB teams, researchers and local authorities. Since the virus continues to fuel the wildest rumors, like the treatments are actually poisoning experiments from “white” doctors on African populations. The teams also fears being overwhelmed. “I’m afraid of the popularity and the risk that exists for many patients coming from throughout the region, even in neighboring countries, to try to reach the centers for treatment,” worries Dr. Abdourahmane Batchily , Ebola coordinator for the forest Guinea. For Dr. Anglaret, successful treatment would be a “fantastic story.” The head of Inserm fears rather “failure and the immense disappointment that would come as a result.”
The role of outreach teams, “psychosocial” NGO staff, remains of high importance. “That will not be easy to explain to patients taking these drugs, or their families, with the suspicion surrounding the disease and its spread,” admits Fernanda Falero.
“Some say that white people have had the medication for a long time and expected that many blacks would die before giving it,” says Dr. Batchily, tired from the battle he leads for the field since the early days of the epidemic. He would like things to go faster, “You Westerners, you need four or five years to test a drug. We in Africa are pressed for time.”
“The treatments for viruses are always long, look at HIV: so do not expect a quick result,” culminates Conakry Doctor, Sekou Conde, director of care facilities participating in the Guinean cell response against Ebola. The first full results will not be expected before spring, but the mortality rate could fall, if successful, more quickly in treatment centers.