COVID-19: Remedies, Red Tapes and Risks – Is Science Losing its Integrity?
WEALTH OKETE
Saturday, 9 May 2020
Although, there are still quite a number of naysayers who oppose everything 'corona-like', holding on dearly to their daring beliefs that the Coronavirus is a propaganda, and that the whole world is being scammed by 'who knows who?', it appears that more persons are beginning to face and brace up for the sad reality of the inevitable existence of this ravaging disease. And as the case figures rise daily, so also do the number of supposed remedies rise, most of them proffered by people who have been configured to say something, do something, prove something, even when it's obvious that they don't have answers. The world is replete with such remedies, and tricks, and claims that could cure the Coronavirus disease, kill its virus, or boost one's immunity, so that he doesn't even have to worry about contracting the disease.
Countries like China, Singapore and Philippines [1], including Madagascar, Ghana, Tanzania, Liberia, Equatorial Guinea, Guinea-Bissau and Zimbabwe of Africa, are currently propagating the use of uncertain and unproven herbal remedies as cure for the disease [2][3]. Whereas these countries hold that the so-called remedies they promote are yielding the kind of results that would be expected, the World Health Organization (WHO) frowns at such nonscientific, unethical procedures. Concerns have been raised by scientists who fear the possibility of malaria resistance with the use of COVID-Organics, a herbal cure originating in Madagascar that has spread across some African countries [4]. Artemisinin, from the sweet wormwood plant, Artemisia annua, is a major constituent of COVID-Organics [2], and also one of the two components of most malaria combination therapies, along side Lumefantrin. With the majority of malaria cases and deaths coming from Africa, one would wonder whether it is really a good idea to sacrifice malaria for COVID-19. It should be recalled that just a few weeks ago, Africans had raised alarms against being used as 'guinea pigs' for newly developed COVID-19 vaccines [5]. But then, it appears that we'd rather be our own 'guinea pigs', than accept to do same for the world.
Well, it's not just herbal remedies that the scientific and health agencies should be clamping down on. There's also the rush associated with publishing results of researches, and so-called clinical trials that fall short of acceptable standards by pharmaceutical companies, research institutions and collaborating scientists, with the excuse that these are directed towards an urgent discovery of drugs and vaccines against COVID-19. Urgent enough, before it kills us all.
Ideally, the process of developing a drug or a vaccine and certifying it for mainstream consumption usually takes years. Years of animal studies and clinical trials and data analysis, to ascertain the safety and efficacy of such a remedy. It would be both useless and unethical to approve drugs that are effective and unsafe, or safe and ineffective, or both unsafe and ineffective for public use. The ability of any drug to treat a disease is often considered in comparison to other pre-existing drugs for that disease, to a non-therapeutic substance (a kind of placebo), and to the absence of the drug (in a control group). Whether or not a drug is found to significantly affect the progress of a disease is dependent on results from such studies in humans (clinical trials) usually involving up to three phases. From recent observations however, it appears that some researchers may have bypassed some of these protocols in their haste to find a COVID-19 cure [6][7].
But, a viable argument would be one that places the sentimental and dishonest actions of these scientists, against the bureaucracies and protocols associated with the long, slow process of drug discovery, development and certification, especially considering the spate of new cases and deaths from the Coronavirus. Wouldn't it be okay to just certify whatever remedy is stumbled upon, without going through all those formalities and cutting through the red tapes? Would science hurt if we do? Does science now count more than human life and survival? Are the outcomes of such 'trials' not enough evidence for science to build upon? Is the goal not to get a curative or prophylactic therapy for COVID-19?
In their recent paper, 'Against pandemic research exceptionalism' [8], Alex John London and Jonathan Kimmelman, argued that the goal of research, an ideal scientific research is to discover solutions that provide both scientific and social value. And by this they meant that, research must provide enough results or solutions as it were, to better science and to help stakeholders make better decisions for the overall good of the public. Researches must be able 'to produce the information that multiple actors need to make decisions that implicate health, welfare, and the use of scarce resources'. They proposed that it was both possible and realistic to conduct science ethically, without hurting both science and the human race, without losing on either ends.
London and Kimmelman recommended five conditions upon which proper scientific research must be conducted;
· Importance: Clinical trials should address key questions, using best fit therapies, whether curative or prophylactic, and adopting strategies able to detect effects that are both meaningful and clinically useful.
· Rigorous design: Trials should be designed to detect specific and clinically relevant effects, whether positive or negative. Randomization and placebo administration must be incorporated into researches.
· Analytical Integrity: Operation protocols for designs and analysis must be prespecified.
· Proper, detailed reporting: Results from trials, whether positive or negative, should be reported completely and without bias. A common challenge here is when scientists are more eager and quicker to deposit positive outcomes from studies, earlier than they do the negative outcomes, especially in preprint journals.
· Feasibility: Trials must be workable within a given time frame, both in terms of accessing participants and resources, as well as implementing results from them.
Regardless of the urgency we are faced with in the current pandemic, the high standards demanded for proper science must not be compromised for anything, not haste or fear or sentiments. These standards must be upheld and adhered to at all cost. Not just because the integrity of science depends on it, but also because research is not just about finding solutions, any solution, but about finding lasting, effective solutions. Clinical trials, whether on novel or existing drugs and vaccines, or on herbal remedies must follow acceptable guidelines, without bypassing protocols or bureaucracies or adopting research strategies that yield skewed, biased results. Researches, especially in this pandemic must be tailored to focus first on protecting the integrity of science, while fastidiously working out potential solutions. It is true that we may not get all the answers as quick as we need them, or even get them all correctly at once, but we must not hurry; speed has always been and still remains an archenemy to proper science. Any hastily, poorly conducted research could incur more costs in the long run and its aftermath may haunt us for a lifetime, long after COVID-19 is gone.
Science has earned the world's trust over the years, it should not start losing it now.
| about WEALTH OKETE
Fascinated by the intricate, inter-connected concepts in Biochemistry, Wealth has watched his interest in biomedical research and science communication grow over the years. He currently writes health articles for the Weekend edition of the Nigerian Observer newspaper, and still manages to flaunt his irresistible flare for writing in poems and inspirational pieces. He is a serving corps member in Western Nigeria who takes great delight in educating and mentoring his students, and does not hesitate to volunteer whenever the need arises.
The views expressed in this article are the author`s own and do not necessarily reflect the editorial views of the African Science Literacy Network (ASLN).
References
[1] – More herbal 'cures' for COVID-19 | Health | The Guardian
https://www.google.com/amp/s/guardian.ng/features/more-herbal-cures-for-covid-19/
[2] – Coronavirus: What is Madagascar’s ‘herbal remedy’ Covid-Organics? | Africa | Aljazeera
[3] – Senegal approves Madagascar’s anti-COVID-19 drug | Anadolu Agency
https://www.aa.com.tr/en/africa/senegal-approves-madagascar-s-anti-covid-19-2drug/1833942
[4] –Unproven herbal remedy against COVID-19 could fuel drug-resistant malaria, scientists warn | Science | AAAS
[5] – Coronavirus: Africa will not be testing ground for vaccine, says WHO | BBC News
https://www.google.com/amp/s/www.bbc.com/news/amp/world-africa-52192184
[6] – Researchers rush to test coronavirus vaccine in people without knowing how well it works in animals | Health | STAT
[7] – The Science of this Pandemic is Moving at Dangerous Speeds | WIRED
https://www.wired.com/story/the-science-of-this-pandemic-is-moving-at-dangerous-speeds/
[8] – London, A. J. and Kimmelman, J. Against pandemic research exceptionalism. Science. 368 (6490) : 476-477
https://science.sciencemag.org/content/368/6490/476