I

t should be the right time to make a difference now that the Ebola outbreak in West Africa reminds us that there is indifference in the world. Various scientific efforts have come up with ways to combat this deadly virus, which may not be 100 percent perfect, but could help to minimize fatalities.

Ebola is an example of a neglected infectious disease. It mostly occurs in poor countries in Africa that do not have resources to develop their own vaccine or drugs. If a remedy can be made available, the countries would not have the money to buy it. This holds true for various third-world diseases, such as dengue fever, malaria, tuberculosis and so on.

Money really matters. The possibilities stretch from vaccines to anti-Ebola drugs, hyper-immune sera and small interfering ribonucleic acid (siRNA). The products have never entered the market as there is no major interest among pharmaceutical companies to fund human trials. The cost-return is seen to be long as it is a problem affecting the poor, while conducting human trials would cost millions of dollars in funding.

The major interest of developed countries, such as the United States, Canada and European states, is that the Ebola virus has the huge potential to be deployed as a bioterrorism agent. It is plausible to think that these countries may have surreptitiously developed and stockpiled anti-Ebola drugs and vaccines for their own use. Their interest, therefore, would primarily be aimed at troops or embassy staff assigned to high-risk areas.

The major impediment in developing vaccines and drugs is Ebola'€™s very high fatality rate, which can reach 90 percent. Working with such an agent requires the highest level of biosafety, known as BSL-4, in which a facility must have negative pressure and the operator must wear the most-secure lab coat with an oxygen-producing machine. This kind of lab facility does not exist in most developing countries, including Indonesia.

The first line of defense that needs to be sought for viral diseases is a vaccine. The most promising candidates are DNA vaccines or recombinant adenovirus and vesicular stomatitis viruses.

A DNA vaccine is a recombinant plasmid that contains the fragment of an Ebola gene. When injected into a muscle, our cells will adopt it and create an Ebola protein that triggers immune response.

The recombinant virus vaccine is a non-pathogenic adenovirus or vesicular stomatitis virus that carries an Ebola gene, so as the virus multiplies in the human body, it produces an Ebola protein that ultimately triggers immunity to the virus itself as well as to the Ebola.

These candidates have been verified efficacious in nonhuman primates. Published in 2003-2005, these forms of Ebola vaccine have just undergone clinical trials.

An anti-Ebola drug is also an option. Favipiravir, a universal anti-RNA-virus drug, may somewhat reduce the incidence of Ebola infection. Another approach is what is called drug repurposing; that is, using approved drugs for other illnesses to be used to create a new medication. Clomiphene and toremifene, which have been approved to treat infertility and breast cancer respectively, have been found to reduce Ebola in animal experiments.

Sera that contain an antibody to the Ebola protein can be utilized as a form of therapy as well as prophylaxis after exposure. Doctors have been treating patients with sera from people who have recovered from the illness for millennia. Animal sera can replace human sera following immunization with the pathogen.

Moreover, we can produce a monoclonal antibody to the Ebola virus.

An experimental drug based on a monoclonal antibody, containing a homogenous antibody against Ebola only and developed by Mapp-Biopharmaceutical in San Diego, California, was first tested on two Americans who had been infected with Ebola. Both have reportedly recovered.

We understand very well that developing and testing Ebola vaccines and drugs is not easy. It needs modern, secure facilities and vast amounts of money.

Nonetheless, we should strive to ensure that this Ebola crisis does not spread beyond Africa and threaten everybody worldwide. In this modern world, ignorance could cost the entire planet.

Clinical trials can take up to eight years or even longer before any vaccine or drug becomes available. The ethical issue is whether we can distribute a vaccine or drug that has not been fully tested. Can we shorten the process? Considering the extreme threat of pathogenic Ebola, the simple answer is we need to do our best.

Everybody will comprehend that our best is sometimes not good enough. For a lot of people, providing evidence that the remedies are not toxic to the human body and have no long-term side effects, to be able to cure a small part of the victim is priceless. We are not permitting Africans to be used as experimental guinea pigs. We lessen the sadness. We reduce the global risk.

The best thing for Indonesia is to support African governments to prevent and control the spread of the virus, so we should send resources to support them.

The cost would be incalculable if the virus arrived here. At home, the public should be vigilant and a protocol to control an Ebola epicenter should be established. Certain hospitals at the possible entry point may have to be prepared, and special areas within them must be fully isolated and separated from other patients.

In terms of generating ammunition against Ebola, we should produce preparedness remedies for prophylaxis and therapy. We don'€™t require a pathogenic Ebola virus to do it. With synthetic DNA and protein technology, a vaccine and hyper-immune inventions are doable.

In testing a vaccine'€™s efficacy, we should collaborate with foreign countries and conduct lab experiments there.

Being actively engaged in a global health issue, this nation would gain valuable experience in reducing the potentially disastrous impact and pandemic of Ebola and other diseases.