Aug 082014
 

As is customary in today’s world of controlled and manipulated information, the current focus of public attention is an unprecedented African outbreak of ebola, a virulent disease with a high mortality rate that can be accompanied by the almost complete breakdown of normal bodily functions, as well as by extreme incontinence and bleeding from all orifices.  A horrific way of dying.

Of the five types of ebola, the currently active Zaire ebolavirus is the most aggressive and lethal, with an extremely high mortality rate, up to about 88%.

But mass media are not asking possibly the most fundamental question about ebola – given that ebola has been known to the international health community since 1976 (featuring in about 34 outbreaks) why has a vaccine not been developed long ago?

The answer lies in the unwillingness of Western pharmaceutical companies addicted to high profits to even consider undoubtedly costly investment in vaccines and treatments for infectious diseases that are rampant in the poorest countries of the world, mostly in Africa.

The speed and unpredictability of the current outbreak has confronted the world with the fearsome possibility that this disease could even spread to the US and the West.  As soon as ebola was perceived as no longer confined to Africa, the world which has until now turned its back on ebola and a number of other tropical infectious diseases was galvanized into action. There is a significant risk that the mythical global village might become an uncomfortable reality.

The present head of the World Bank, whose professional life began with handling an infectious disease outbreak in Haiti, has announced that the World Bank will donate $200 million to an ebola fund to be administered by the World Health Organisation (WHO).  WHO has set itself a target of $100 million, of which only $30 million has so far been contributed by its member states.

Until recently this ebola outbreak was concentrated in Guinea, Liberia, and Sierra Leone, three of the poorest countries in the world. Liberia is ranked 179 on the UN Human Development Index, with an average life expectancy of 56.11. Liberia is ranked 175, with a life expectancy of 60.6, while Sierra Leone is at rock bottom, at 183, with a life expectancy of 45.56. All these countries have been ravaged by war and conflict, and are amongst the most corrupt in the world. Poverty is widespread, communication is limited; borders are not just porous, but practically non-existent.  Many people live in remote small communities completely out of touch with everything.

One unsettling feature of the current outbreak lies in the fact that ebola has also taken root in large cities, where it is much harder to identify and eradicate. Because there is little faith in thoroughly discredited public institutions, any government-declared ebola emergency is often taken with a grain of salt. Even those health workers who commit to the fight against ebola frequently lack the most basic forms of protection.  Unsurprisingly, about 100 health workers have already died.  The surviving health professionals live with the knowledge that their commitment can lead to a nasty death whose symptoms are all too familiar. Laboratory workers and other support staff are reluctant to have contact with blood, urine and stool samples, out of fear of the consequences.

WHO will initially focus on sending in teams of well-equipped infectious disease specialists who, notwithstanding their expertise, will nevertheless be functioning in a less than optimal environment.  One WHO doctor already in Africa confessed that he had to overcome resistance from his wife when he decided to put his hand into the fire. The hope is that this can turn the tide, and can confine ebola to its home continent, preventing spread to the West.

The primordial Western terror of ebola is best exemplified by the current furious debate in the US, with some alleging that the Centres for Disease Control acted irresponsibly when inviting infected US doctors infected with ebola back to the US for high quality care, therefore exposing the entire population of the West to a possible outbreak. Alternatively, it could be said that, while Africans are expendable, the predominantly white population of the developed world must honour its kith and kin.

Because the West has until now perceived ebola as an African infection, it has been reluctant to fund research into an ebola vaccine. Now that ebola could possibly morph into a worldwide pandemic, the west is coming up with considerable resources, to both contain the outbreak and to produce a vaccine. If the rigorous procedures for testing such vaccines continue to be applied, it could take two years before a vaccine is available.   If an ebola outbreak has by then escaped Africa and has established itself outside Africa, including in the West, demand for the vaccine will vastly exceed supply. The company selected to produce the vaccine will take full advantage of this situation, by driving prices and profits through the roof.  The weak will have to go to the wall, unvaccinated, while the powerful immunize themselves.

It can take as long as 21 days for identifiable ebola symptoms to develop. The latency period normally lasts about 6-10 days. During this period ebola is normally indistinguishable from the flu.  And the earliest symptoms of ebola – very high temperature, vomiting, and diarrhea – are not exactly confined to ebola. This is when there is a considerable risk of infection and contamination.

If ebola spreads to the West, with its large anonymous conurbations, it would be difficult to control. In the absence of a vaccine, the probability of deaths would increase greatly.  At this stage Western media are filled with uninformed chatter about vaccines and serums.  Several companies have been working to develop an ebola vaccine, but in the US, where most of this research is concentrated, most have been denied funding by the National Institutes of Health.

It has emerged that much of the funding for ebola research has aimed, not at protecting Africans and others from this highly infectious tropical disease, but at protecting western governments from the possible deliberate use of biological agents by non-state entities, or terrorists.

Since 11 September Western governments have been fiercely lobbied by pharmaceutical companies which, out of naked commercial self-interest, have raised alarm in high places by inflating the threat to the West from terrorist groups. This alarm, with its far-reaching economic and health consequences, has been concealed from the general public.

For example, a UK company called Acambis persuaded governments of a serious risk that smallpox might be deliberately used by terrorists. Acambis went one step further, convincing many governments that they had to prepare for mass vaccination if they wanted to protect their populations. The fact that a much cheaper policy of containment had helped WHO eradicate smallpox from Africa was conveniently overlooked.

Acambis invested a lot of money into lobbying senior public health officials in ways that stretched the concept of medical ethics.  Enormous quantities of smallpox vaccine were ordered by gullible governments, Acambis shareholders laughed all the way to the stock exchange, and Acambis was eventually sold to a US company for a fancy price.  As smallpox vaccine has a limited life expectancy those governments that bought it were also committing to replace their stocks at regular intervals.  It was money for jam. By the way, Acambis was not at all alone in this.

Governments may have been conned into spending many hundreds of millions of dollars on a public health mirage devised by the public relations representatives of immensely profitable pharmaceutical companies.

Although today’s terrorist organisations are much better funded and organised than their equivalents in the aftermath of 11 September, they do not in fact pose a great risk.  Biological agents are very blunt instruments at best. Once released and dispersed, they cannot be confined to enemy populations.  Especially if the release has been successful, they will eventually come back to bite the very organisations which released them, medically and politically. Since the war in Syria we know that terrorist groups can now produce chemical weapons, which are strategically much more promising than biological agents.  They can be targeted at specific areas, while their capacity to generate fear and terror is undiminished.

Various US and Canadian private companies and institutions have worked to develop an ebola vaccine, but have so far been denied the National Institutes of Health funding which, in the US, is the precondition for phase one trials on human beings. Stimulated and excited at the possibility of an international move to prepare for an outbreak of ebola, US and other companies will already be lobbying senior public health officials to secure a contract to develop and produce an ebola vaccine. Given growing international concern about a possible international ebola pandemic, the sky will be the limit for the companies cutting each other’s throats for this plum contract.

A US observer recently pointed out that “Right now, more money goes into fighting baldness and erectile dysfunction than hemorrhagic fevers like dengue or ebola.” A table of global pharmaceutical spending in 2013 shows that “neglected diseases” including ebola received almost no funding.

At its session on 24 May 2013 the World Health Assembly in Geneva adopted resolution WHA66.12 listing 17 neglected tropical diseases. In supporting this resolution, which interestingly enough did not list ebola as a neglected tropical disease, WHO Director-General Dr Margaret Chan spoke eloquently about and pleaded for the demise of neglected tropical diseases:  “The size of the problem is immense as these diseases have always inflicted immense suffering to more than one billion poor ‘voiceless and faceless’ people, causing stigma and social exclusion particularly for women and children who ‘suffer in silence.’”

Dr Margaret Chan’s heartfelt plea went unnoticed outside of the World Health Assembly, like previous pleas of this kind. For example, malaria was ignored for decades by western governments and pharmaceutical companies, although it was an endemic source of misery for successive Third World generations.

The time has come for the BRICS governments, which collectively wield considerable economic power, to demonstrate their commitment to the developing world by establishing a well-endowed fund whose aim is, in consultation with WHO and relevant centres of expertise for infectious diseases, to fund research into and development of effective and inexpensive vaccines and treatments for infectious diseases afflicting the population of developing countries. They would fund the development of independent research institutes and production facilities to produce vaccines and medicines for sale to poor countries at below cost, and to developed countries for twice or three times as much as the cost price.

This would go some way towards rectifying the historical imbalance between developing and developed worlds in this regard. It would also enormously strengthen the political/economic relationship between BRICS and developing countries.

 

 

Link to World Health Assembly resolution WHA66.12 http://www.who.int/neglected_diseases/WHA_66_seventh_day_resolution_adopted/en/

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