Wellcome Trust Reaction To US Bioethics Commission Brief On Ebola

Dr Jeremy Farrar, Director of the Wellcome Trust, has said:

“Covering a range of aspects related to Ebola this report rightly focuses on the ethical challenges raised by the epidemic, also proposing how the US might strengthen its domestic and global response to such health emergencies.

“One of the seven recommendations of the Commission critically addresses the ethical issues around drug and vaccine trial design, about which disagreement and delay have seriously affected the ability to test the effectiveness of interventions. There are valid differences of opinion about the merits of all trial designs, but, in agreement with the WHO's recommendations last year, the Commission concludes that a range of different trial designs should to be considered – including placebo-controlled trials and adaptive randomisation.

“A framework that would allow multi-stage trials of several types, which could be quickly combined and adapted to test potentially effective treatments as soon as they are identified, is essential. The debate needs to move on from the current false dichotomy between placebo-controlled and single-arm trials, which has been generated by the erroneous insistence that only one of these is acceptable.”

Piero Olliaro, Trudie Lang, Jake Dunning and Peter Horby of the Centre for Tropical Medicine and Global Health at the University of Oxford submitted a short document that was considered by the US Bioethics Commission as part of their evidence gathering. A copy of this document is available on request and Piero Olliaro is available for interview today. Peter Horby leads an international collaboration to fast-track trials of candidate Ebola treatments in West Africa, which is funded by the Wellcome Trust.