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"  The worst-ever Ebola outbreak has climbed to an estimated 1229 deaths and 2240 infections, according to the World Health Organization&amp;#039;s (WHO) August 19 report. Despite decades of research, a cure or vaccine remains elusive, though several experimental treatments are in various stages of testing. Last week, a WHO committee decided that it is ethical to give experimental drugs and vaccines to those infected with Ebola or at risk of contracting the disease, as long as the patients give informed consent. But two major questions remain: What treatments should health officials focus on, and how many doses will we need? Through data analysis, epidemiologist Oliver Brady and two colleagues have estimated that health organizations and governments need to stockpile tens of thousands of doses of these treatments to battle the current outbreak. Their research, published in Nature today, also suggests that up to 30,000 people would have already qualified if these treatments had been available from the start, by conservative estimates.  If the magnitude of this estimate is correct, it means that health experts need to quickly increase development and production to fairly distribute these investigational drugs. But it&amp;#039;s unlikely that this will happen in time to combat the current outbreak. Promising Candidates For the first time ever, scientists have several candidates for Ebola treatments and vaccines. Many have been shown to be effective in primates. However, none have been tested in humans. So far the WHO is looking at products from three different categories: blood-derived treatments, vaccines, and anti-virals. A blood-derived treatment is made of antibodies that came from the blood of someone who recovered from Ebola. The experimental blood-derived treatment ZMapp, which comes from genetically modified tobacco plants that produce the antibodies, has received a flurry of media attention in recent days because the handful of infected patients who received the drug appear to be improving. However, experts caution that it&amp;#039;s impossible to know whether Zapp is actually effective because of the small sample size. One vaccine is slated to begin the first phase of clinical trials this fall; another one is scheduled to begin trials in early 2015. The NIH is developing the fall vaccine with Okairos, a pharmaceutical company owned by GlaxoSmithKline. The Canadian government has also said it will donate 800 to 1,000 doses of an experimental vaccine to West Africa.  The WHO says that it&amp;#039;s looking at several anti-virals as well; however, at the press conference, the WHO spokesperson declined to name the possible treatments. The Race to Production Now that the WHO has decreed it ethical to try experimental Ebola drugs and vaccines, how much would we actually need for this current outbreak? Brady and his collaborators first identified groups that would need treatments, such as the infected and their families, medical teams and staff that handled the dead, and essential workers who are necessary for local services and humanitarian aid. Then they looked at probable levels of exposure  for each group to calculate how many people might need treatment. Brady says that the 30,000 is a rough estimate. However, since the researchers found that the number of people who would have needed treatment already is in the tens of thousands, the analysis highlights how far this outbreak has spread, compared to the rural Ebola outbreaks in the past.  According to the WHO, there are very few doses of these promising drugs available, and some, such as ZMapp, have already run out. To provide fair treatment to the people who want the experimental drugs, their development, production, and distribution would need to scale up quickly.  Not everyone is on board with this approach, though. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, recently wrote in the New England Journal of Medicine that it&amp;#039;s unlikely this epidemic will be solved by a &amp;quot;miracle cure.&amp;quot; He warned that sending unproven medicine could backfire, creating even more tension between medical teams and patients. Instead, he suggested that we should depend on the standard practices of outbreak control for the current situation. Nevertheless, at the end of this month, the WHO will conduct a meeting to decide what experimental treatments and vaccines to pursue. It&amp;#039;ll take at least three to five months to develop, produce, and distribute the drugs, and the WHO cautions that even then, supplies will be so low that they&amp;#039;re unlikely to make much of a difference in West Africa this time around. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.popularmechanics.com/science/health/a13004/how-many-doses-of-experimental-ebola-drugs-do-we-need-2497751/>