Ebola Viral Disease in West Africa: A Threat to Global Health, Economy and Political Stability

Omoleke, Semeeh Akinwale; Mohammed, Ibrahim; Saidu, Yauba

In the past, minimal efforts were devoted to develop control tools for EVD. This limited attention is understandable from both economic and technical perspectives. Technically speaking, much remains unknown about the biology and pathogenesis of EVD. 87 For instance, there seems to be no validated surrogate marker or immunological correlate of protection that can guide product evaluation in clinical trials. As such, trials may require clinical endpoints such as severe disease outcomes (e.g. death) or endpoints, which may be challenging to measure. From an economic perspective, the epidemiology of the disease, rare and sporadic outbreaks that occur in regions with very weak purchasing power, offers comparatively little or no market incentives for industries to invest millions of dollars to develop products against EVD. This economic obstacle, however, has changed in recent years owing to the risk of importation of the virus, potential misuse of the virus in bioterrorism, frequent outbreaks and the need to protect specific risk groups including health professionals, aid workers and military personnel amongst others. These interests have led to the evaluation of several clinically approved drugs in animal models. For instance, activated protein C 88 and inhibitors of factor VIIa 89 have shown some promising results in controlling coagulation disorders in animal models. Similarly, an RNA-based treatment strategy, namely, the use of antisense oligonucleotides, has been shown to interfere with transcription and thus viral replication. 90 In contrast ribavirin, a broad spectrum anti-viral agent against many hemorrhagic viruses, was shown to have no effect on EVD. 91 Although some of these strategies are promising, there are still substantial scientific and pragmatic issues that require elucidation.