Facts Not Fear: Will we find a cure?

In the last of our “Facts Not Fear” Ebola Q&A posts we focus on the research being done to find effective vaccines and treatments for Ebola. The Wellcome Trust has partnered with a number of organisations to fund vaccine safety trials, research potential therapies, and we initiated a fast-tracked funding scheme for public health research in this area.

This post aims to help answer some of the frequently asked questions about the work being done, and how long it might take to move from positive research results to delivery of vaccinations or treatments to those who need them most. 

Who is most at risk of contracting Ebola?

Currently front-line workers in the West African countries affected by Ebola – for example those treating or caring for patients, burial workers, cleaners – are most at risk of contracting Ebola. Next most at risk are other people in these affected countries who have close contact with patients. The risk to the general population in places like the UK is very limited.

Is there a cure for Ebola?

At the moment there is no cure for Ebola. The treatment that is currently available includes supportive care such as fluid management, antipyretics (medication that reduces fever), analgesics (painkillers) and anti-emetics (drugs against vomiting and nausea). 

What’s the difference between a vaccination and a therapy/treatment?

Vaccines aim to provide protection to healthy people at risk of contracting the disease, whereas therapies aim to treat those who have already contracted the disease.

We heard about experimental treatments like ZMapp – what are they and why are we not using them on more people?

ZMapp is an investigational drug that comprises three antibodies that target a surface protein of the Ebola virus. There is some evidence that the drug can be effective in animal models, however, there is no clear evidence that the treatment works in humans. Although ZMapp was used compassionately in a few sick healthcare workers, it has not yet been tested in any clinical trials to determine its true effectiveness.

Before potential treatments can be rolled out to everyone they need to be adequately tested for their safety and efficacy. This requires safety trials in healthy volunteers first, followed by efficacy trials in volunteers with Ebola disease. There are some potential drugs that have already been tested in humans for other diseases but have not been tried till now to see if they work against Ebola. Such drugs can go straight into efficacy trials.

In order to do these trials you need sufficient doses, and currently ZMapp doses have been depleted. As ZMapp is made in tobacco plants the whole process can take as long as six months to grow. Researchers are working hard to scale up production and to investigate alternative quicker non-plant mechanisms to make the drug, but this is not a simple task. There are supplies of other candidate drugs which may be deployed.

We hear that lots of research is being funded – when will we get results/a treatment that we can use?

The scientific community is working hard with the pharmaceutical industry, governments, civil society, philanthropic foundations and the WHO to fast-track research into potential treatments and vaccines.

Currently vaccine safety trials are being conducted in healthy volunteers in Europe, USA and Africa. If there are no safety issues the next step will be to carry out trials to test their efficacy in at risk volunteers in the affected countries. There is hope that these could start as early as December 2014, but even then clear results may not be available for several months.

It is really important that we move fast, but we also have to move safely. We also have to accept the reality that new drugs and vaccines will need to be tested in the three most affected countries, but their health resources are stretched to the limit and beyond, so it is not going to be easy for trials to be conducted against this background.

Read our previous “Facts not Fear” posts to find out why this outbreak has been so hard to control and what needs to be done to stop the spread of Ebola. Visit the Wellcome Trust news pages to find out what the Trust has been doing to help fund Ebola research.