Twelve Lessons from the AIDS Crisis for Finding an Ebola Treatment

 There is no perfect solution for Ebola virus disease (EVD). There will be no “cure” for at least some years.

Don’t fall into the “If it’s a new disease therefore we need a new drug” trap. We don’t have time for that. It took fifteen years to develop highly effective drugs for HIV.

Look for a combination therapy that works – we can’t wait for the perfect “silver bullet” cure. “Don’t let the perfect become the enemy of the good.” Better, more specific anti-Ebola drugs may take years to develop but right now use what we already have that proves effective.

Use what works. If there is a credible report of something that actually is effective against Ebola, quickly test that in a simple clinical trial. Once we find two or three medicines that each helps retard Ebola disease or reduces mortality somewhat, then we will have an effective combination therapy. Then keep testing other potential treatments to try to improve that combination.

Do not delay simple quick clinical trials. DO THEM NOW! They don’t cost much, and they only take three weeks.

Line up and test all known antiviral drugs to see which ones may work against Ebola. [The Economist magazine editorial in its Ebola cover edition of 18 October 2014 gives this exact same advice.] Not doing this was the big mistake in the HIV crisis.

If a treatment works, USE THE CORRECT DOSAGE.


Wall sign in Monrovia, Liberia, 2014

Science sometimes works counterintuitively. For instance, aspirin is an anti-viral drug. It works as an NF-kB inhibitor. It strongly boosts the immune system, helps prevent damage to blood vessels, and is beneficial in treating HIV disease. Despite its anti-coagulative effect aspirin might have a positive effect in treating Ebola. 5-ASA (Asacol) an aspirin analogue drug is not anti-coagulative and can be used against Ebola. Other NSAID drugs like ibuprofen should also be tested.

Do a cost/benefit and a difficulty/benefit analysis of potential treatment strategies. Using plasma with antibodies from Ebola survivors may or may not work or be very effective; but it is guaranteed to be a very complicated, expensive and tedious approach to treating Ebola.

Selenium (sodium selenite) at moderately high doses has already proved to reduce the mortality rate in this epidemic by about 45%. In several other hemorrhagic fever epidemics, it has reduced the death rate by approximately 60%. Test other anti-viral drugs on top of selenium immediately, especially Truvada.

We will not be able to turn the corner on this epidemic without effective treatments. Consider the HIV epidemic in South Africa before and after distributing ARV drugs to HIV patients. Infections stopped increasing and deaths went down once ARVs were finally used.

Keep your mind open to novel solutions. Think outside the box. Most things are discovered - outside the box.


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