The Foreign Minister of the Republic of Liberia, Mr. Augustine Kpehe Ngafuan, has expressed his happiness that a sub-regional effort is being undertaken to build collaborative systems that will lead to building the technical and scientific capacities to ethically respond to emergency situations in the sub-region.
The Foreign Minister said he was especially happy because he was one person who had to trot from one city to the other during the height of the Ebola crisis trying to bring the global attention to and woo support for the fight against the Ebola virus disease.
The Minister, who spoke Wednesday, August 26, at the formal opening of a two-day sub-regional Ebola virus disease (EVD) collaboration meeting, heaped praises on Dr. Stephen Kennedy and his team at the Partnership for Research on the Ebola Vaccines in Liberia (PREVAIL) and all others, who contributed immensely to the organization of the Monrovia gathering, which is ongoing at the Monrovia City Hall.
The two-day meeting is aimed at deliberating and gaining better appreciation of the complex ethical challenges occasioned by rapidly increasing clinical trials and identifying effective vaccines and therapeutic agents in emergency situations and how to seek sub-regional strategies to effectively intervene in these emergencies.
Speaking further, the Minister said, “Today with the sirens of ambulances not wailing through the streets of Monrovia, Conakry or Freetown and CNN, Al-Jazeera and BBC not zooming in on and reporting about helpless mothers with their babies tumbling to death on the doorsteps of ETUs, and doctors and health workers losing their precious lives in the process of trying to save others, we can now afford the luxury of sitting back and conducting a post-mortem on how we performed in terms of treading the tightrope of responding quickly and effectively to one of the world's most deadly health crises and at the same time trying to do so within the perimeters of medical ethics and regulations.”
According to the Foreign Minister, during the height of the Ebola emergency, pandemonium and fear reigned supreme in the nook and corner of worst-hit nations. He added: “We did not have the time to fully reflect and consider all the many and varied implications of our actions. We had to act and act fast.”
Touching on ethical issues that might have arisen during the Ebola crisis, he asked: “But what did we do right? What did we do wrong? In fact, what is considered 'wrong' in a medical emergency? Can wrong be narrowly defined as straying beyond the strict borders of medical ethics and regulations? Or should we have a flexible definition such that if a good outcome is achieved, the means to the achievement of that outcome should not matter?”
“In Liberia, the Ebola crisis exposed us to many fears in many ways and put many medical practitioners and family members on the horns of a dilemma, being forced to make difficult and uncomfortable choices. For a person who wants to live, there is not much of a choice between virtual certainty of death within 21 days versus the slim probability of survival within 21 days if a therapeutic drug is administered regardless whether such a drug has been fully approved or not.”
However, he stated that the Ebola crisis brought into sharp focus a debate as to what exactly can be considered “ethical.” “Medical ethics or regulations would require that before a drug is sanctioned for use in humans, it must have gone through all the stages of trials to ascertain its efficacy and potential side effects. However, going through the loops, of all the ethical requirements is time-intensive and may not jive with the urgency and speed that dealing effectively with health emergencies such as Ebola will require.
He disclosed that the Ebola epidemic was “massive”, so much so that it led the United Nations Security Council, for the first time in its history, to pass a resolution declaring the crisis a threat to global peace and security.
As Foreign Minister Ngafuan concluded, he wished that deliberations from the gathering would yield fruitful and successful outcomes, which will give clarity as to how they respond in future health emergencies.