E-DRUG: Ebola and Essential Medicine issues
[Thank you for sharing this Murtada. We would welcome further discussion on
essential medicines life-or- death issues that cropped up during the Ebola
epidemic and also that have occurred or might occur during outbreaks of other
emerging infections. BS. Moderator]
Dear E-Drug Colleagues,
Greetings and best wishes for 2015 from Freetown!
Now that the dense dust of Ebola appears to be thinning out and settling down,
thought I would stimulate some discussion in this forum on some of the
essential medicines life-or- death issues that cropped up and may have
unresolved, as far as I am aware in Sierra Leone, in the hope that some
clarity or consensus may emerge in readiness for the next epidemic.
I will start with the choice between Oral versus Intravenous
fluid replacement as part of the supportive care package.
I read in social media here in Sierra Leone about claims that whereas a
fully Sierra Leonean-managed treatment facility primarily used IV
therapy, this was not the case with some other foreign-managed
facilities who used ORS instead . The Hastings Treatment Centre using mainly IV
therapy as part of their overall Ebola supportive care was given much credit
for their relatively high survival rates.
It is probably too early to see peer-reviewed evidence on this matter,
where this exists, but I believe it is an important area worth
discussing even from an academic-only perspective.
At some point at the peak of the social media debate, and as I saw it as a
life-and death, usually within days!, I suggested out of sheer
desperation, that I did not see why the use of ORS and IV should be
mutually exclusive and that, therefore, the two sides should consider
reducing their preference by 50%, and replace with the other option(OR
or IV), to harmonise their fluid replacement approaches. This of course would
be in addition to any other best clinical practices, including monitoring of
other blood electrolytes.
I would be very interested in views on this matter, including the
related stock investment strategies to adopt at the outbreak of the next
As I say, there are quite a few Essential Medicines issues
that caught my attention and I intend to raise them here, as we move on
with the fight to get Ebola out of Sierra Leone and indeed West Africa.
Murtada M. Sesay BPharm. MSc. MMI. MCIPS.
Health Supply Matters
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