When we first heard about the Ebola outbreak in West Africa months ago, it was a local crisis. Not anymore. It is now spreading exponentially, faster than it can be contained. There is talk of Ebola bringing down the entire African economy. The President has referred to it as a matter of national security. 



If any community understands what it means to be globally connected, Korean Americans certainly can. Our origins from another country define who we are. So it may be no surprise that many of us are involved in efforts that are international, or global, in nature.

As I interviewed three CKA members about the Ebola crisis, I learned that the one of our members' companies, Inovio Pharmaceuticals (NYSEMKT:INO) is actually working on a vaccine for Ebola. But in the course of my conversations, I also learned quite a bit about infectious disease, drug development, and the challenges faced by the developing world. 

I hope you do too. I want to thank Drs. Richard Chin, Joseph J. Kim, and Annette Sohn for their unique insights into this global crisis and for helping us stay connected to the crisis unfolding in West Africa.

Sam Yoon
Sam Yoon, President
"We are past due for a pandemic"

Richard Chin
Former CEO, OneWorld Health
When Dr. Richard Chin was serving as CEO of OneWorld Health, a Gates-funded non-profit, he was immersed in the world of infectious disease. He said what's happening in West Africa "is a tragedy, terrible. But not surprising." 

He said pandemics - which are epidemics, or contagious outbreaks, but on a global scale - are like earthquakes. You may not know exactly when they will happen, but they eventually will.

Dr. Chin says we are past due for one. But when a small earthquake hits underdeveloped countries like Liberia, Sierra Leone, and Guinea, the effects can be disastrous.

Dr. Chin has been in the drug development business for many years. He knows that the economics of drug development can differ radically, depending on the disease. OneWorld Health was created to level the playing field for diseases that affect poor people and therefore don't attract enough commercial capital on their own to develop treatments for them.

He told me of one example from his time at OneWorld Health. Malaria affects hundreds of millions of people and almost a million deaths. It has been known since the 1970's that an effective drug can be extracted from the wormwood plant, which is grown in China. However, it can take up to two years from the time a seed is planted until the drug can be manufactured. Malaria treatment was therefore expensive and often in short supply. 

OneWorld Health perfected a way to manufacture the special ingredient through a special process, which was shared with international pharmaceutical giant Sanofi. Sanofi now manufactures hundreds of millions of doses and sells them at cost. 

Unfortunately, this success story is more the exception than the rule. "Our system is not set up to encourage people to develop drugs that won't make money."

"Without government or foundation funding, not a lot of work can be done."
Joseph J. Kim
CEO, Inovio Pharmaceuticals 
Dr. Joseph Kim agrees with Dr. Chin. Without funding from government or nonprofits, developing drugs for third-world diseases is very difficult. 

Founded by Dr. Kim fourteen years ago, Inovio Pharmaceuticals is now a publicly-traded company. The demands of his shareholders require that he focus on drugs that make money, like cancer treatment. However, Inovio has worked on a variety of other diseases, including HIV/AIDS, and Ebola.

In fact, Inovio worked with a team of scientists on a study, published last year (see below), showing the possibility of an effective vaccine for Ebola. 

One of the scientists he collaborated with on that study was Gary Kobinger of the Public Health Agency in Canada. Dr. Kobinger made recent headlines for advancing an experimental drug, "ZMapp" which treats those already infected with Ebola. Zmapp was shown to be effective in treating monkeys, and many believe it may have saved the lives of two American doctors who were infected by Ebola. 

A vaccine to protect the general population from Ebola would obviously be a major breakthrough. "I can't say too much about it right now," said Dr. Kim. "But we're looking for ways to get our vaccine into human testing."

The challenging economics of drug development for poor countries is what led Dr. Kim to join the International Vaccine Institute (IVI), which is funded by the World Health Organization (WHO). Like OneWorldHealth, the goal of IVI is to level the playing field in the development of vaccines that don't attract commercial investment. 

Interestingly, Korea, which at one time was a major recipient of international aid, is now a major donor. "South Korea," he noted, "is now one of the largest funders of IVI. In fact, their headquarters is in Korea, on the campus of Seoul National University."

"The developed world has a responsibility to help... but ultimately the responsibility lies among the people themselves." 
Annette Sohn
Director, TREAT Asia
Dr. Annette Sohn is dedicated to addressing AIDS in Asia through therapeutics, education, and training. As director of TREAT Asia, a division of amfAR, the Foundation for AIDS Research, she lives and works in Bangkok, Thailand. 

She sees firsthand how the social, historical, and cultural challenges of a developing country can affect the way infectious diseases spread and get treated. The contrast can be stark.

For very poor countries like those in West Africa, "the problem isn't just not having enough doctors. It's also about having basic hygiene in hospitals and communities." Dr. Sohn said, "In the U.S. we take for granted that we have such good infection control procedures. But in West Africa, they may not even have the basics -- gloves, gowns, masks..." 

Though Dr. Sohn's experience is rooted in Southeast Asia, she understands the context of countries that have come out of war, such as Cambodia and Vietnam. It takes time for a country's development status to rise from the ashes of civil conflict. War happens to be a much more recent memory in Sierra Leone, Guinea, and Liberia, which explains in part why they are farther behind the countries she works in.

Factors like access to education, particularly for young girls; the ability to retain educated citizens and prevent brain drain; governments that are less corrupt - she said these things matter when it comes to a country's ability to control epidemics. 

Developing these factors has to be a long-term partnership between the international community and the country. And Dr. Sohn said that ultimately the people of that country must assume responsibility for their own future. 

But clearly in the case of the Ebola outbreak, there is both a short-term crisis and a long-term problem to be solved. I asked Dr. Sohn about the role of the international aid agencies currently working on the crisis in West Africa. She noted that there have been funding cuts to global public health programs for years, and we may be paying for it.

"When you have a fire, you can't just make a firefighter appear in that moment." Whether it is creating local capacity or mounting a stronger global response, "We're going to look back at this and say our response wasn't what it have been. We have to do better."
Read More

"Cuts at W.H.O. Hurt Response to Ebola Crisis" 
New York TImes
September 3, 2014
If the W.H.O., the main United Nations health agency, could not quickly muster an army of experts and health workers to combat an outbreak overtaking some of the world's poorest countries, then what entity in the world would do it?

"Induction of Broad Cytotoxic T Cells by Protective DNA Vaccination Against Marburg and Ebola"
Academic paper by Inovio and a team of scientists featured in a peer-reviewed academic journal Molecular Therapy, published by Nature.
July 7, 2013