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Evaluating Ebola Therapies — The Case for RCTs

THE NEW ENGLAND JOURNAL OF MEDICINE                                                                                 Dec. 3, 2014
By Edward Cox, M.D., M.P.H., Luciana Borio, M.D., and Robert Temple, M.D.

...Studying investigational therapies for EVD presents scientific, practical, and ethical challenges. Not surprisingly, there has been substantial debate about the best and most appropriate study approaches.2,3 It is generally agreed that a trial with a concurrent control group, in which patients are randomly assigned to receive the test drug plus the best available supportive care (BASC) or to BASC alone, would be the most efficient and reliable way to evaluate the safety and effectiveness of candidate products.

 Some people in the health care community, however, have argued against such trials, urging instead use of a historical control — that is, making investigational drugs as widely available as their supply allows and then comparing mortality rates among treated patients with rates that would have been expected absent the drugs, on the basis of past experience with EVD.

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World Bank announces $160m for Ebola-hit Sierra Leone

AFP                                                                                                                     Dec. 3, 2014

FREETOWN --World Bank chief Jim Yong Kim announced a $160 million two-year economic recovery plan on Wednesday to help impoverished Sierra Leone battle the worst Ebola outbreak on record.

Kim said after a closed-door meeting with President Ernest Bai Koroma in Freetown the cash would go towards regional operations centres and emergency response teams in the hard-hit west and north of the country.

The aid would also focus on the country's floundering farming sector and rural job creation, he told reporters...

Kim flew to Conakry later on Wednesday, where he was expected to meet government officials and health experts.
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http://www.straitstimes.com/news/world/more-world-stories/story/world-bank-announces-200-million-ebola-hit-sierra-leone-20141204

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Ebola crisis: French President Hollande to visit Guinea

French President Francois Hollande is to arrive in Guinea, becoming the first Western leader to visit a nation hit hard by the deadly Ebola virus.

He will deliver "a message of solidarity" to Guinea, where more than 1,200 have died of Ebola.

Meanwhile Guinea is to trial a new Ebola test that will deliver results six times faster than current methods.

The outbreak was now "stable" in the West African country, the World Health Organization (WHO) said last week.

France has pledged 100m euros (£79m; $125m) to help tackle the disease by opening several care centres in Guinea, a former French colony.

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http://www.bbc.com/news/world-africa-30241374

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UN security council criticises discrimination against those from Ebola-hit regions

THE GUARDIAN                                                    Nov. 21, 2014
THE UNITED NATIONS --The UN security council has criticized travel bans against nationals from Ebola-hit countries.

Last month the Australian immigration minster, Scott Morrison, announced Australia would stop granting temporary visas to visitors from west Africa. The security council statement criticised such blanket bans and urged countries to maintain links with affected countries.

“The security council expresses its continued concern about the detrimental effect of the isolation of the affected countries as a result of trade and travel restrictions imposed on and to the affected countries as well as acts of discrimination against the nationals of Guinea, Liberia, Mali and Sierra Leone,” said Julia Bishop, the Australian foreign mniister who was presiding over the session Thursday.

The council statement also described the Ebola outbreeak in Africa as "a threat to international peace and security..."

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WHO plans to speed development of Ebola rapid test

CENTER FOR INFECTIOUS DISEASE RESEARCH AND POLICY
By Lisa Schnirring                                               Nov.18, 2014

Quicker and simpler diagnostic tests for Ebola could go a long way in helping break chains of disease transmission in West Africa's outbreak region, the World Health Organization (WHO) said today, as it unveiled two new initiatives to expedite their development.

The WHO said it hopes new efforts—similar to those under way to test and deliver an Ebola vaccine—can compress the development of a rapid test in months instead of years.

A Navy worker extracts RNA from a patient sample at a Naval mobile lab in Liberia. US Army Africa

Standard reverse-transcriptase polymerase chain reaction (RT-PCR) tests used in mobile and other labs in the outbreak are very accurate when conducted by trained staff, but they require a full tube of blood, take 2 to 6 hours to get a result, and costs around $100 per test, the WHO said today in a statement....

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Queen Fears Ebola Push at Expense of Other Killer Diseases

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The Shifting Ebola Epidemic

NEW YORK TIMES                                                                                         Nov. 16, 2014

EDITORIAL

Recent gains in controlling the Ebola epidemic in West Africa have been encouraging, but they offer no reason for complacency. In Liberia, the hardest-hit country, the rate of new infections has declined in some areas, and several treatment units have been reporting empty beds for more than a month. But in adjacent Sierra Leone the number of new cases has shot upward, while in Guinea, where the epidemic started, the incidence of new cases appears to have stabilized over all, with growth in some districts and declines in others. All told, Ebola has infected more than 14,000 people in West Africa and killed more than 5,000 of them...

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Bats’ Link to Ebola Finally Solved

 

THE DAILY BEAST                                                                                                           Nov. 11, 2014
By Carfrie Arnold

A new paper outlines five steps required for a virus to ‘spill over’ from bats to humans. But don’t just blame the bats—deforestation and hunting are to blame, too.

These nocturnal fliers might do some good, but their association with night, rabies, and All Things Creepy means that, at best, we tolerate them. Adding to their negative aura is recent research showing that bats can be the source of infectious diseases like SARS and Ebola, as well as lesser-known pathogens like Hendra and Nipah virus.

It’s all too easy to blame bats for causing these human pandemics, including the most recent (and deadliest) Ebola outbreak. After all, these viruses hang out in bats in between outbreaks—trace any outbreak of these viruses back far enough and you will find a bat.

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GOP chairman rips ‘deadly incompetence’ of UN Ebola response

CONGRESSIONAL HEARING: House Foreign Committee Chairman blasts WHO, while AID urges funding to address Ebola hotspots.
(Two stories, scroll down)

THE HILL                                                                                                                           Nov. 13, 2014

A top Republican is calling for a new strategy to fight Ebola overseas — one that does not rely on the embattled World Health Organization (WHO).

Rep. Ed Royce (R-Calif.), chairman of the House Foreign Affairs Committee, slammed the organization for what he called “deadly incompetence” in the battle against the disease.

“Unfortunately, we are paying the price for early failures,” Royce said at a hearing, arguing that the WHO “repeatedly downplayed the crisis.”

Rep. Gerry Connolly (D-Va.) said he has “no confidence” in the WHO.
“WHO contributed to the spread of this virus and to a high mortality rate, frankly, because of its cronyism and its incompetence,” Connolly said.The

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Are we asking the wrong questions about Ebola?

BBC NEWS MAGAZINE                                            NOV. 11, 2014

By Ben Carter

The Ebola virus has killed about 5,000 people since March - but one scientist who is studying the statistics says this is not the best figure to consider if we really want to understand the current state of the outbreak and how to beat it.

 

 

A total of 4,960 people have died from Ebola this year according to statistics released by the World Health Organisation on 4 November. More than half of those cases - 2,766 - were in Liberia.

But this cumulative figure, which is widely reported, can only go one way - up. It gives no meaningful insight into how the outbreak has developed says Hans Rosling, professor of global health at the Karolinska Institute in Sweden....

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http://www.bbc.com/news/magazine-30011521

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