Systemic exclusion of pregnant people in Ebola trials reveals gender bias, regulatory gaps, and colonial research legacies
Original framing: “[Correspondence] Pregnancy as exclusion criterion in Ebola research: not again” — The Lancet
Recent pharmacokinetic modeling indicates that many Ebola therapeutics can be safely administered during pregnancy, contradicting the blanket exclusion rationale. However, the paucity of data stems from a lack of intentional study design rather than inherent toxicity. Robust, ethically designed phase‑II trials are scientifically feasible and necessary.
The exclusion of pregnant people from Ebola research is not a neutral scientific decision but a manifestation of gendered power, colonial legacies, and regulatory inertia that silences Indigenous and marginalised voices.
By weaving Indigenous birthing wisdom, historical accountability, cross‑cultural humility, and rigorous scientific data into co‑designed ethical frameworks, we can reshape trial architecture to be inclusive and trustworthy. Funding streams must be reallocated to support maternal sub‑studies, while community‑embedded pharmacovigilance ensures safety and transparency. Ultimately, embracing cultural narratives and trickster insights reveals the absurdity of protectionist exclusion and paves the way for equitable, life‑saving interventions in future outbreaks.