Coronavirus (539) More deaths, no benefit from hydroxychloroquine (5) E-DRUG: Caution on Chloroquine and Hydroxychloroquine for COVID-19 in Africa

3 May, 2020

The message below is forwarded from thye E-DRUG discussion forum.

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E-DRUG: Caution on Chloroquine and Hydroxychloroquine for COVID-19 in Africa

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[important warning: now by a large group of African scientists. Let us be careful with off-label use until we have good evidence from RCTs. We also have fake and substandard (H)CQ tablets in circulation in Africa. WB]

Chloroquine and Hydroxychloroquine for the Prevention or Treatment of Novel Coronavirus Disease (COVID-19) in Africa: Caution for Inappropriate Off-Label Use in Healthcare Settings

by: Pascale M. Abena, Eric H. Decloedt, Emmanuel Bottieau, Fatima Suleman et al.

Am. J. Trop. Med. Hyg., 00(0), 2020, pp. 1-5

https://www.ajtmh.org/content/journals/10.4269/ajtmh.20-0290

Abstract. The novel severe acute respiratory syndrome-coronavirus-2 pandemic has spread to Africa, where nearly all countries have reported laboratory-confirmed cases of novel coronavirus disease (COVID-19). Although there are ongoing

clinical trials of repurposed and investigational antiviral and immune-based therapies, there are as yet no scientifically proven, clinically effective pharmacological treatments for COVID-19.

Among the repurposed drugs, the commonly used antimalarials chloroquine (CQ) and hydroxychloroquine (HCQ) have become the focus of global scientific media, and political attention despite a lack of randomized clinical trials supporting their efficacy.

Chloroquine has been used worldwide for about 75 years and is listed by the WHO as an essential medicine to treat malaria. Hydroxychloroquine is mainly used as a therapy for autoimmune diseases. However, the efficacy and safety of CQ/HCQ for the treatment of COVID-19 remains to be defined. Indiscriminate promotion and widespread use of CQ/HCQ have led to extensive shortages, self-treatment, and fatal overdoses. Shortages and increased market prices leave all countries vulnerable to substandard and falsified medical products, and safety issues are especially concerning for Africa because of its healthcare system limitations. Much needed in Africa is a cross-continental collaborative network for coordinated production, distribution, and post-marketing surveillance aligned to low-cost distribution of any approved COVID-19 drug; this would ideally be piggybacked on existing global aid efforts.

Meanwhile, African countries should strongly consider implementing prescription monitoring schemes to ensure that any off-label CQ/HCQ use is appropriate and beneficial during this pandemic.

E-DRUG@Healthnet.org

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Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org