Reports from Bloomberg suggests that Uncle Sam had high chances of stopping Ebola before it spread, but didn't due to failure to invest enough dollars to have it mature in time. Had doctors not been stuck in the federal bureaucracy for four years, the world would have been better prepared for the epidemic. The drug’s path through the research labs of the Washington-Baltimore corridor talks of much bureaucracy and shows that the federal government still isn’t good at producing drugs.

In July, Kent Brantly and Nancy Writebol, both American medical workers in Liberia, became stricken with Ebola hemorrhagic fever after treating dozens suffering from the disease, which has a mortality rate of 50 percent to 90 percent. They were rushed doses of an experimental cocktail of Ebola antibodies called ZMapp. Both recovered within the month and later met with President Obama.


President Obama meets with Kent Brantly and his wife, Amber, in the Oval Office on Sept. 16
Mapp Biopharmaceutical, the company that developed ZMapp, is also in a way a White House project. It’s supported exclusively through federal grants and contracts that go back to 2005. The antibody mixture hadn’t yet passed its first phase of human clinical trials, but after the two Americans were infected with Ebola, the Food and Drug Administration granted emergency access to ZMapp.

Since appearing in Guinea in December, Ebola has spread to five West African countries and infected 5,864 people, of which 2,811 have died, according to the WHO's Sept. 22 report. This number is widely considered an underestimate. The CDC’s worst-case model assumes that cases are “significantly under-reported” by a factor of 2.5. With that correction, the CDC predicts 21,000 total cases in Liberia and Sierra Leone alone by Sept. 30.

Could a large stockpile of ZMapp have halted the spread of Ebola?


Ebola Virus
No one can say. What’s certain is that the U.S. government hasn’t done a good job taking the idea behind ZMapp and turning it into a treatment. The technology for antibody cocktails such as ZMapp has “been around for a few decades,” says Robert Garry, a professor of microbiology at Tulane University. “This is something that, given the emergency, the government could have moved a little faster on, quite honestly.” The treatment came into the hands of a little-known Pentagon agency in late 2010, but ZMapp sat there dormant, waiting for a contract, for two years.

After 2001, the Pentagon budget for biological and chemical defense rose from $880 million to $1.12 billion. Since then, roughly a third of its total budget, about $3.9 billion, has been designated for a list of “biological threat agents.” The list is classified, but it now numbers 18, according to a 2014 analysis by the U.S. Government Accountability Office. Two separate arms of the federal government, with a $5 billion annual budget between them, now were focused on the same set of problems but not talking to each other well. And neither was accomplishing what was needed most: producing drugs.

The summary is that that agencies solely granted fast-track contracting authority are underfunded and as such the time it takes for a drug to come out of research labs into trials and through to production equals the time to produce a Hollywood movie. ZMapp Biopharmaceutical since launch in 2003 didn't get an investor for about a decade, when they did get funding, it was merely to keep the lights on but not enough to get products to trial. As thus rather than develop a vaccine, which triggers the body to create its own antibodies—defenses against a virus, ZMapp worked to develop monoclonal antibodies, a ready-made supply that can be introduced into the body as a therapy after infection.

The antibody itself had been deemed a worthy idea but needed to go through a review process before any actual money could be disbursed to develop it. And that’s when the ZMapp program really stalled because most projects surrounding this matter lacked solid technical oversight, and proper coordination for years. Other issues stemed from older employees who focused on publishing research and securing academic prestige rather than driving poducts through early trials and to shipping. Its veery tricky working in government agencies and in contracting, there are certain things and processes onde cannot fight.

Without contract delays, Mapp could have completed trials necessary to stockpile the drug.

Biological hazards are difficult to plan for and its alwayas very hard to spend money on something that hasn’t happened yet. As long as there’s not sufficient money to address every one of the targeted diseases, the system always has to make a decision based on what’s the greatest threat today, not tomorrow.

It’s too early to say whether ZMapp was vital to the Americans’ survival. There were a limited number of doses available. Mapp ran out after having given doses to the two Americans, a Spanish priest, and doctors in two West African countries, although it declined to say how many. And that raised fair questions: Why hadn’t the promising treatment gone through human clinical trials sooner, and why were there so few doses on hand?

Many agencies involved in this need money, others just can’t move quickly, and the U.S., until now, hasn’t made Ebola a priority. and this is why we don’t have an Ebola countermeasure.


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