Evolving Challenges and Research-Needs Concerning Ebola

As the recent Ebola outbreak and global responses to it have continued to evolve, several major questions concerning research in developing countries arise, about which social science research is critically needed. Much of the debate about deployment of Ebola treatments and vaccines has focused on whether randomized clinical trials or other study designs or compassionate use should be employed (e.g., whether, in studies, standard of care or an alternative intervention should be a control arm). Recently, favipiravir was found to decrease death rates from 30% to 15% among patients with low to medium viral levels, leading to calls to use this drug more widely—to administer it instead of placebos in other studies and to roll it out more broadly in the population as a whole—which poses additional key questions. Vaccine trials are also advancing, with the completion of phase I trials.4 Several additional dilemmas are thus emerging concerning ethics and public health that have still received little, if any, attention.