The World Health Organisation (WHO) has called for countries to improve access to two lifesaving Ebola medicines, in its first guidelines on the viral disease, published on Friday.
The recommendation follows review and
analysis of clinical trials for the monoclonal antibodies mAb114 (known as
Ansuvimab or Ebanga) and REGN-EB3 (Inmazeb), which have demonstrated clear
benefits for people who have tested positive for Ebola, which is often fatal.
This includes older persons, pregnant and
breastfeeding women, children, and newborns whose mothers were confirmed to
have Ebola within the first seven days after birth.
The clinical trials were conducted during
Ebola outbreaks.
WHO said the largest trial was carried out
in the Democratic Republic of the Congo, demonstrating that the highest level
of scientific rigour can be applied even during Ebola outbreaks in difficult
contexts.
The UN agency also provided recommendations
regarding therapeutics that should not be used as treatments, which include
ZMapp and remdesivir.
The new guidance, published simultaneously
in English and French, will support healthcare providers caring for Ebola
patients as well as policymakers involved in outbreak preparedness and
response.
It complements clinical care guidance that
outlines the optimised supportive care that Ebola patients should receive –
from the relevant tests to administer, to managing pain, nutrition and
co-infections, and other approaches that put patients on the best path to
recovery.
“This therapeutic guide is a critical tool
to fight Ebola,” Dr Richard Kojan, co-chair of the expert group selected by WHO
to develop the guidelines, and President of ALIMA, The Alliance for
International Medical Action, said.
“From now on, people infected with the
Ebola virus will have a greater chance of recovering if they seek care as early
as possible.
“As with other infectious diseases,
timeliness is key, and people should not hesitate to consult health workers as
quickly as possible to ensure they receive the best care possible.”
Fellow co-chair Dr Robert Fowler from the
University of Toronto in Canada noted that Ebola used to be perceived as “a
near certain killer,” but advances in care and therapeutics over the past
decade have revolutionised treatment of the disease.
“Provision of best supportive medical care
to patients, combined with monoclonal antibody treatment – MAb114 or REGN-EB3 –
now leads to recovery for the vast majority of people,” he added.
As access to these treatments remains
challenging, especially in poor areas, WHO said they should be available where
they are most needed, namely in locations where active Ebola outbreaks are
occurring, or where the threat of outbreak is high or very likely.
The UN agency stands ready to support
countries, manufacturers and partners to improve access to the two medicines.
“We have seen incredible advances in both
the quality and safety of clinical care during Ebola outbreaks,” Dr Janet Diaz,
lead of the clinical management unit in WHO’s Health Emergencies programme,
said.
“Doing the basics well, including early
diagnosis, providing optimized supportive care with the evaluation of new
therapeutics under clinical trials, has transformed what is possible during
Ebola outbreaks.
“This is what has led to development of a
new standard of care for patients. However, timely access to these lifesaving
interventions has to be a priority.”
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