Nurses wearing protective suits escort a man infected with the ebola virus to a hospital in Monrovia, Liberia, 25 August. Photo: Getty
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Why releasing untested ebola drugs was the right thing to do

Drug trials rarely tell the whole story as many drugs have side effects that emerge only after deployment in the population at large. Yet unexpected effects can sometimes be surprisingly good.

Scientists do the best they can, but no drug is properly tested until it is fully deployed. And sometimes the result is better than anyone could have hoped.

In all the hand-wringing over whether it was right to release untested drugs to treat ebola victims, an important truth has gone largely unreported: even when completed, drug trials rarely tell the whole story. Many drugs have side effects that emerge only after deployment in the population at large. If you want proof, look at the millions of reports of adverse effects on the US Food and Drug Administration’s new OpenFDA website.

It’s worth noting, however, that unexpected effects can sometimes be surprisingly good. Take BCG. The Bacillus Calmette-Guérin vaccination was designed to protect against tuberculosis but it does far more. It stimulates an immune reaction against bladder cancer, for instance – the vaccine, delivered directly into the bladder, is now a standard treatment for this disease. It has also been used to fight multiple sclerosis and diabetes. No one knows exactly why this immunity-boosting effect takes place.

Other vaccines also have unexpected protective effects. Studies have shown that, when deployed in Africa, the measles vaccine cuts deaths from diseases other than measles by a third. The way it stimulates the immune system seems to enhance the body’s defence against infections. As a result, pneumonia, sepsis and diarrhoea – the most common causes of death in developing countries – are reduced by vaccinating against a completely unrelated disease.

We have known this for a while. In the early 20th century a physician logged the survival rates of children when vaccination was introduced to Sweden. Even though tuberculosis mostly kills older children, the vaccination had an effect on babies, too: those who had received it stood a much higher chance of reaching their first birthday. Follow-up trials in the US and UK in the 1940s and 1950s suggested that BCG-vaccinated children had a 25 per cent lower death rate from diseases unconnected to tuberculosis.

More recent studies have shown that vaccines for both smallpox and BCG can reduce susceptibility to lymphoma, leukaemia and asthma. Some researchers suggest that the rise in allergies and asthma in developed countries might be linked to the phasing out of the BCG vaccines.

There are still improvements to be made. This year, the World Health Organisation (WHO) has announced that it is looking into tweaking the sequence in which certain vaccines are administered in developing countries, after a team of experts concluded that the way they interact might be having an adverse effect on girls’ health.

It is not the first time that gender-specific effects have been noted after vaccination. In 1992, WHO withdrew a high-dose measles vaccine that had been shown to increase girls’ susceptibility to infection. No one is advocating that we drop any vaccinations – they save far more lives than they put at risk. But just changing the order in which they are given might help them save even more lives.

In the messy world of pharmaceuticals, nothing is ever certain. Whatever the outcome, releasing the untested ebola drugs was the right thing to do. In a crisis, we sometimes have to jump and hope for the best. Or maybe even better. 

Michael Brooks holds a PhD in quantum physics. He writes a weekly science column for the New Statesman, and his most recent book is At the Edge of Uncertainty: 11 Discoveries Taking Science by Surprise.

This article first appeared in the 20 August 2014 issue of the New Statesman, What the Beatles did for Britain

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PMQs review: Theresa May shows how her confidence has grown

After her Brexit speech, the PM declared of Jeremy Corbyn: "I've got a plan - he doesn't have a clue". 

The woman derided as “Theresa Maybe” believes she has neutralised that charge. Following her Brexit speech, Theresa May cut a far more confident figure at today's PMQs. Jeremy Corbyn inevitably devoted all six of his questions to Europe but failed to land a definitive blow.

He began by denouncing May for “sidelining parliament” at the very moment the UK was supposedly reclaiming sovereignty (though he yesterday praised her for guaranteeing MPs would get a vote). “It’s not so much the Iron Lady as the irony lady,” he quipped. But May, who has sometimes faltered against Corbyn, had a ready retort. The Labour leader, she noted, had denounced the government for planning to leave the single market while simultaneously seeking “access” to it. Yet “access”, she went on, was precisely what Corbyn had demanded (seemingly having confused it with full membership). "I've got a plan - he doesn't have a clue,” she declared.

When Corbyn recalled May’s economic warnings during the referendum (“Does she now disagree with herself?”), the PM was able to reply: “I said if we voted to leave the EU the sky would not fall in and look at what has happened to our economic situation since we voted to leave the EU”.

Corbyn’s subsequent question on whether May would pay for single market access was less wounding than it might have been because she has consistently refused to rule out budget contributions (though yesterday emphasised that the days of “vast” payments were over).

When the Labour leader ended by rightly hailing the contribution immigrants made to public services (“The real pressure on public services comes from a government that slashed billions”), May took full opportunity of the chance to have the last word, launching a full-frontal attack on his leadership and a defence of hers. “There is indeed a difference - when I look at the issue of Brexit or any other issues like the NHS or social care, I consider the issue, I set out my plan and I stick to it. It's called leadership, he should try it some time.”

For May, life will soon get harder. Once Article 50 is triggered, it is the EU 27, not the UK, that will take back control (the withdrawal agreement must be approved by at least 72 per cent of member states). With MPs now guaranteed a vote on the final outcome, parliament will also reassert itself. But for now, May can reflect with satisfaction on her strengthened position.

George Eaton is political editor of the New Statesman.