Tough challenges for testing Ebola therapeutics.

At a briefing of United Nations officials on treating Ebola patients in western Africa with medicines and blood products in November last year, one question came up again and again: “Why is it taking so long?” Officials wanted to know why Ebola patients who have been evacuated to Europe or North America have had higher survival rates than those who remained in the outbreak countries, says scientist Martin Friede, who leads the technology transfer team at the World Health Organization (WHO) in Geneva. “Some of these patients had received a whole range of drugs – everything and the kitchen sink – but I explained to them that we don’t know what helped them to recover. Was it the clinical care? Was it the kitchen sink?” he says. “That’s why we must do clinical trials to find out which drugs are safe and effective in these patients,” says Friede, a former vice-president of development at California biotech company Apovia Inc., who joined WHO in 2003.