About a week ago came the momentous news from the Democratic Republic of Congo that a cure for Ebola was in sight. Well, wait a minute – not so fast. Scientists avoid making such sweeping conclusions so early. Rather, the researchers involved guardedly described the breakthrough as coming from “new treatments that reverse the symptoms of Ebola dramatically”. The data is preliminary, they stressed. All the same, they left no doubt that a major milestone against one of the most terrifying diseases of our time had been achieved.
I won’t, dear reader, tire you with needlessly complicated mumbo-jumbo on the experimental drugs involved. They are two, actually. One is classified as mAb114. The other is known as REGN-EB3. In the course of clinical trials in the eastern Congo provinces of North Kivu and Ituri, which are currently in the grip of the latest Congolese Ebola outbreak, the two drugs showed so much promise as to make the research teams suspend the trials so that the drugs can be made widely available to Ebola patients.
Two other experimental drugs involved in the trials were found to be less “efficacious” (that’s the odd term medics prefer, as opposed to the more straightforward word “effective”). One was the Canadian-developed ZMapp, which had been hailed as a possible miracle drug during the 2014-16 Ebola epidemic in West Africa. With the Congolese trials, it didn’t quite measure up. Anthony Fauci, one of the leaders of the clinical study, says their data showed mAb114 and REGN-EB3 “are clearly better” than ZMapp.
Without going into too much confusing detail, what the two successful treatments have in common is that they are based on a certain technique of cloning antibodies. An antibody is a kind of cell in the body that is released by the immune system to fight disease. When you get immunised against a particular disease, a small dose of pathogens of that disease is injected into your body where it triggers the release of a mass of antibodies which effectively make you immunised. It’s like a little poison put into your body, and the body reacts with waves of anti-poison.
Just as remarkable as the latest dramatic advance against Ebola is the identity of a key player behind it all. He is a distinguished Congolese microbiologist, Prof Jean-Jacques Muyembe. Currently the director of Congo’s National Institute for Biomedical Research, he was a lead partner in the clinical trials whose other partners were the US National Institute of Allergy and Infectious Diseases (NIAID) together with the World Health Organisation. Muyembe is acknowledged by his peers as one of the top Ebola researchers in the world. Lancet, a leading medical journal, described him in an article as “the Ebola hunter”.
The successful new Ebola treatments are the culmination of work Muyembe pioneered during an earlier Ebola outbreak in 1995 in Kikwit, in south-western Congo. At the time, the doctor started treating the patients with a mix of antibodies from survivors. Years later, researchers at NIAID picked up on this therapy and isolated the antibodies from those survivors – and the results led to mAb114.
It all began in 1976 at a Catholic mission hospital in Yambuku, a remote village in northern Congo. That was where, quite unexpectedly, Muyembe first encountered what the world would later come to know as Ebola. A mysterious haemorrhagic disease was killing people in a horrible way, with blood oozing out of their bodies during their final death throes.
A team sent out from Kinshasa led by Muyembe came to investigate. Initially he thought it was typhoid, but tests were negative. A blood sample from a sick nun also defied diagnosis in Kinshasa, where the labs were dilapidated (a problem that has greatly hampered Muyembe’s work as indeed that of other medical researchers in Africa). It is then when Muyembe decided to send a sample to the Institute of Tropical Medicine in Antwerp, Belgium, where a certain other microbiologist called Prof Peter Piot worked. Prof Piot’s team analysed the sample and identified what we now call the Ebola virus. (Piot was to later earn more global acclaim for his groundbreaking research work on HIV).
When the Kikwit outbreak occurred, local medics didn’t know what they were dealing with. Upon arrival on the scene, Muyembe immediately recognised the symptoms as Ebola’s, but to be sure, he sent samples to the Centers for Disease Control and Prevention in the US, who confirmed in a matter of days that it was indeed Ebola.
Muyembe’s career and his battles against Ebola is a great, inspirational African story. However, he has one burning task he believes remains. Most Ebola outbreaks occur in the Congo. But nobody knows where the virus really springs from. Is it from bats, as Muyembe earlier suspected? Studies don’t give a clue. For him to feel he has achieved full victory over Ebola, his search for the virus’s origins will continue.