Ebola: Why Children Are Last to Be Treated in Medical Crises

The current Ebola outbreak in the Democratic Republic of Congo has claimed over 3,000 lives, with children under five facing a particularly grim prognosis. According to Doctors Without Borders, the mortality rate for this age group exceeds 60%. However, the vast majority of deaths are attributed to a dearth of medication and proper administration techniques for young patients, rather than the disease itself.

A key issue in treating children is the exclusion of those weighing less than 20 kilograms (about 44 pounds) in the ongoing EBO-PEP study, which assessed an experimental antiviral drug called obeldesivir. While children weighing over 20 kilograms may be included in future protocols, those under 20 kilograms — roughly 6 years old or younger — will not be part of the treatment. An alternative drug, remdesivir, exists but requires intravenous infusions, which are challenging to administer, especially in an outbreak scenario.

Young children are at heightened risk due to their compromised immune systems, underlying health conditions, and difficulties in accurate symptom description. Moreover, they often cannot be accompanied by parents or caregivers, which is crucial for their recovery. Children also necessitate more frequent monitoring and specialized care.

The report highlights the critical need for separate studies on children and pregnant women, as adult dosages don't translate well to these groups due to differences in metabolism and drug reactions. Marc Biot, access coordinator for Europe at Doctors Without Borders, emphasizes the slower pace of pediatric research compared to adult-focused studies, citing higher costs and the misconception that children can be treated as 'small adults.'

He urges scientists, pharmaceutical companies, and funders to prioritize pediatric research on par with adult studies.