In the Ebola outbreak in Congo, it concerns a variant of the virus for which no medicine or vaccine exists. In the hardest-hit areas, doctors try to keep patients alive. At the same time, there is a race against the clock to find medication to reduce the mortality rate.
Dr. Jacques Makuta from Congo has been working for months in a treatment center for Ebola patients in Bunia, in eastern Congo. Every morning he puts on protective gear to help people as best as possible. Then he goes into the isolation rooms where the patients lie. Pregnant women, babies a few months old, elderly people. No one is spared by Ebola.
Bundibugyo is a rare Ebola variant, partly why there is no medication yet. And every day patients also die. According to the World Health Organization (WHO), about 48 percent of infected people die in the Democratic Republic of Congo.
Hopen op doorbraak
"We do our best to save people and continue with courage," says the dedicated doctor from Alima, an NGO that has set up many Ebola clinics here. Yet he often feels powerless. "What we do is treat symptoms, but we have no medicine to stop the virus. It hurts that we lose so many patients."
But hard work is now underway. In the middle of the crisis area, and even in the hospital where Makuta works, groundbreaking research is taking place. Hundreds of patients in East Congo receive two antiviral drugs, or a combination of them, with the hope that these increase patients' chances of survival.
It is part of an international study, the Partners study, in which Congolese collaborate with international colleagues and universities, pharmaceutical companies, and the WHO.
In a white tent, converted into a laboratory on the grounds of a Doctors Without Borders clinic, sits the Flemish infectious disease specialist Hilde De Clerck from the Institute of Tropical Medicine (ITM) in Antwerp. The institute also participates in the study.
In the field laboratory, blood samples from patients are checked by teams in protective suits. "This way we hope to see that the virus levels in the blood decrease in patients who receive one or both medicines," explains De Clerck. "I do feel the eyes of the world are on us. Of course, we hope for a scientific breakthrough."
Frustrations
This is not the first Ebola outbreak De Clerck has been involved in. As a doctor, she has stood on the front line multiple times. Therefore, she knows how frustrated you can feel as a doctor treating Ebola patients.
"Sometimes you see young people, young patients come in," she says. "Then you think: this one is young, this one will make it. But the virus is so strong, so aggressive, that even young people who are otherwise healthy do not survive."
According to De Clerck, that is precisely why research into new treatments is so important. "It is also truly a tremendously big tragedy for families, who often lose multiple members of the same household. We also see families whose children are left alone. This research is really crucial."
After tests on animals, now study in humans
The trial concerns the drugs remdesivir, an existing antiviral drug, and MBP134, a medicine containing proteins that can recognize and neutralize the virus. Both drugs have been tested on animals and appear to work against the Bundibugyo variant.
The next step is the study in humans. Meanwhile, work is also underway on a vaccine against this variant and people also receive a vaccine that works against the Zaire variant to see if it also offers protection.
Meanwhile, the end of the outbreak is not yet in sight. "We compare Ebola epidemics to a kind of fire, because it spreads like a fire. And it had already spread tremendously before we knew the epidemic was there," says De Clerck. "And we are having difficulty controlling this fire."
People still often go to a hospital too late, if they go at all, when they are already very ill or they die at home and infect others. "Many more people are needed to go into communities, to educate people about Ebola and to conduct contact tracing. We hope more people seek help when they know there is a possible medicine."
Working more carefree
Dr. Makuta from Congo also eagerly awaits a treatment with which he can actually help patients and that can protect him should he contract the virus during his work. "Then we can do our work more carefree."
The results may still take some time, warns De Clerck. "Only when the first results show that one (or both) products work can the medical world gain access to that medicine or medicines."