If Donald Trump cancelled student debt, gave every citizen a guaranteed livable income, and lowered the qualifying age for Medicare to moment of conception, his opponents in the Democratic Party and at Huffington Post would still find a way to spin these policies as reckless and deranged. I say this as no fan of Trump. I believe his economic, social and environmental policies are disastrous, as is his foreign policy. But the usual ways of opposing him have grown pretty tired. They were always pretty lame because they viewed his rise to the presidency as a sudden sickness rather than as a symptom of system that had been sick for a long time.
An interesting example of the “Trump can do nothing right” philosophy can be found in the controversy surrounding the use of chloroquine to treat Covid-19. Although there is compelling evidence that this drug is effective, the media and the political opposition pounced on Trump for having suggested that it showed some promise and should be fast-tracked into use because there isn’t enough time to wait for the usual thorough studies to be published. He was careless in the way he talked about it, but he did mention that it would have to be administered “subject to your doctor’s approval and all of that.” Nonetheless, he was accused, essentially, of selling snake oil, and blamed for the man who poisoned himself by self-administering fish tank cleaner that contained chloroquine phosphate.
Trump’s optimism about chloroquine was inspired by the work of a French doctor, Didier Raoult, who has gone from obscurity to being the sensational “man of the hour” in France. There the situation is just the opposite of what it is in the US, ironically. President Macron and the scientific establishment are reluctant to use chloroquine, but the public and some political opposition are extremely keen to try it.
The following article published by Jeune Afrique explains Dr. Raoult’s biography and describes how the medical establishment in some African countries is much more ready to administer chloroquine treatment, probably because of their familiarity with the drug in the treatment of malaria, and perhaps because of the impossibility of enforcing strict social controls.
One essential caveat about chloroquine treatment is mentioned only briefly in most reports. Dr. Pablo Goldschmidt gave a more detailed explanation in a previous post:
It is the only one that can currently be given. There is no perfect evidence that it will work, but it is better than nothing. It is treated like pneumonia. The difference with classic pneumonia is that the hydroxychloroquine is now added, but only if the doctor does an EKG and determines the patient’s potassium values. The hydroxychloroquine changes the cardiac conductivity and after the administration of three pills there are surprises in the EKG. Not everyone can be treated like this. That is why there were negotiations in France between the health ministry and Didier Raoult, the professor from Marseille who adopted the procedure done in Korea. They said you could do it all over the world, but no, that’s not true. This is only possible for patients who have a doctor supervising their treatment. If you have cardiac arrhythmias due to a drop in the potassium level, the medicine can be worse than the disease. These patients definitely need to be warned, and here comes the big question.
President Macron visited Dr. Raoult on April 9, 2020, but his media spokespersons were careful to say, “A visit doesn’t legitimize a scientific protocol. A visit marks interest by the head of state, for the executive, for clinical trials, to see whether they are promising or not.” They denied Macron was bowing to popular pressure. They said the president is conducting broad consultations as he prepares a major speech on his lockdown exit strategy.
The American media outlet Daily Beast is still calling Dr. Raoult “a bullshit artist.” The American Association for the Advancement of Science asked rhetorically, “Is France’s president fueling the hype over an unproven coronavirus treatment?” According to the article below in Jeune Afrique, at the meeting with President Macron, Dr. Raoult presented his new findings: a study of 1,000 patients treated with chloroquine which establishes a virological cure rate of more than 91%. Dr. Raoult is obviously a very well qualified, respected doctor with long experience. The issue is not whether he is a bullshit artist but whether, in the midst of a pandemic that requires urgent responses, we should try something that has clearly had positive effects and shows promise—and has been used safely for decades in treating malaria—or whether we should wait two years for research to be done the usual, slow way—with randomized trials, one half of the subjects receiving placebos (unethical when giving potentially life-saving treatment), double blind protocols, peer review and finally publication. How many will have died by then, and how many lives will have been ruined by economic contraction?
Rémy Darras and Marième Soumaré, “Didier Raoult the African: on the Chloroquine Road, from Dakar to Brazzaville”, Jeune Afrique, 2020/04/11.
Translated by Dennis Riches
French version :
Rémy Darras et Marième Soumaré, « Didier Raoult l’Africain : sur la piste de la chloroquine, de Dakar à Brazzaville », Jeune Afrique, 2020/04/11.
Born in Senegal, where he spent his childhood, the French doctor and researcher, Didier Raoult, has maintained strong professional and emotional ties with the continent. Many African countries are already using chloroquine to treat people infected with Covid-19.
On 24 March, Professor Didier Raoult walked away from the circle of researchers who were supposed to advise the French president on the pandemic. Disagreeing with the containment policy adopted by France, and preferring a policy of mass screening, the iconoclastic infectious disease specialist has just been disavowed by his peers who are reluctant to endorse the use of hydroxychloroquine in treating the coronavirus.
On Thursday April 9, Didier Raoult was able to measure how far he has come when Emmanuel Macron traveled to Marseille expressly to speak with him in order to “take stock of the question of treatments.” This was a strong political gesture in favor of Didier Raoult’s theses, whose promotion of the use of hydroxychloroquine to treat patients with coronavirus has been highly controversial for several weeks.
A specialist in emerging tropical infectious diseases at the Faculty of Medical and Paramedical Sciences in Marseille and at the Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, the professor with the long hair and a salt-and-pepper beard was still largely unknown to the general public at the end of February. It was then that his support of chloroquine-based coronavirus treatment began to be noticed. Since then, the Frenchman has seen his media and digital-media fame soar. And in the ranks of his most fervent supporters, the African continent is not left behind.
Is this because the chemical compound he uses to treat his patients, hydroxychloroquine, is well known on the continent, where it has long been used to treat malaria? In two publications on tests carried out on about 20 patients and then on 80, the researcher and his teams concluded that “hydroxychloroquine, along with azithromycin, was effective in the treatment of Covid-19.”
This derivative of quinine is now the subject of several studies. Those conducted by Professor Raoult’s team have been criticized by many experts for not complying with standard scientific protocols. At the end of March, however, in France, the High Council of Public Health believed that chloroquine could be administered to patients suffering from “severe forms” of coronavirus.
African countries that opt for chloroquine
In this battle of experts, the country that gave rise to the controversy has also been decisive. At Fann Hospital in Dakar, Professor Moussa Seydi, Head of Infectious and Tropical Diseases, has already administered chloroquine alone to the first 100 patients who tested positive for Covid-19. ”In Marseille, Dr. Didier Raoult has published encouraging preliminary results. The combination of hydroxychloroquine and azithromycin should shorten the duration [of the infection], in order to speed up the healing of the sick,” Moussa Seydi told Jeune Afrique on March 19. In deciding to use this drug, he claims to have relied on the study co-signed by his French counterpart.
Like Senegal, Burkina Faso, Algeria and Morocco have also opted for chloroquine. On March 23, the Ministry of Health of the Cherifian Kingdom [an old term for Morocco] requisitioned national stocks and issued to the directors of the CHU the protocol for prescribing chloroquine and hydroxychloroquine for confirmed cases of Covid-19. The decision was influenced by Chinese research on the subject… and studies conducted by the French researcher, according to a member of the Moroccan committee responsible for the fight against the pandemic.
If Professor Raoult is well known on the continent, it is also because this specialist in tropical and infectious diseases, in addition to having grown up here, has worked a lot here. It was in Dakar that the Frenchman allegedly caught the “research virus.” Born in 1952 in the Senegalese capital, he lived in the building of the African Food and Nutrition Research Office (Orana), created by his father.
Has it all been a twist of fate, which he himself says was “all connected”? It is in front of the Pasteur Institute in Dakar, the laboratory on the front line in the fight against the epidemic in Senegal, that this son of a nurse and a military doctor stationed at the main hospital of the capital took his first steps. He had a childhood marked by happy memories of playing at Anse Bernard beach in Dakar. This made for a “difficult” adjustment when the young Didier Raoult arrived in Marseille, at the age of 9. “Being partially Senegalese, I can’t help but feel concerned about what is happening in Africa,” he says in a video to the Senegalese group eMedia on April 7.
In 2008, Didier Raoult set up a joint research unit of his IHU in the Senegalese capital dedicated to communicable infectious diseases. It was one of the professor’s two African teams, the other one being in Algiers. It claims the production of 10% of scientific publications in le pays de Teranga [another name for Senegal]. “He wanted to have a lot of field staff: epidemiologists, virologists, bacteriologists,” says one of his associates, epidemiologist and biologist Cheikh Sokhna, team leader at IHU Mediterranean Infection in Marseille.
This Senegalese, also director of research at the Institute for Research for Development (IRD), has exchanges regularly with Professor Raoult. This week, the Senegalese team of about 30 people was to file with the Senegalese Ministry of Health a research project on the protocol of the combination chloroquine-azithromycin.
Encouragingly, according to Sheikh Sokhna, the prevalence of coronavirus appears to be lower in areas where the use of antimalarials, such as chloroquine or mefloquine, is common. “It shows very roughly. But other factors will have to be incorporated before definitive conclusions can be drawn,” adds the Senegalese researcher, who is usually based in Marseille but is currently on a long-term mission to Dakar.
This joint research unit is far from being the only innovation driven by Didier Raoult in Africa. In 2012, the French researcher installed a MALDI-TOF at the main hospital in Dakar, which is a mass spectrometer to detect bacteria in a few hours, compared to two to three days with traditional processes. Then, starting in 2015, he set up three small laboratories in Dakar and two villages in the Fatick region (Central West). These are “points of care” (POC), in the jargon of the field, that allow blood or saliva to be collected and quickly identify the cause of the disease or fever so that nurses can propose an effective remedy in a timely manner.
Didier Raoult has done wide-ranging research in Senegal, on malaria, borreliosis, rickettsiosis, malnutrition, hand-washing, “which can reduce diarrheal diseases by 50% and respiratory diseases by 30%.” The French doctor was already working with his Senegalese teams on other less severe forms of the coronavirus family that existed in the country, causing colds and lung diseases.
A “big African brother”
Every year since 2008, he comes to spend a week in Dakar, participating in the IRD Scientific Day organized by Sheikh Sokhna, which brings together health actors and NGOs. It was on this occasion that he met two renowned scientists: the parasitologist Oumar Gaye, from the Cheikh-Anta-Diop University in Dakar (Ucad), and the pharmacist-colonel Souleymane Mboup, virologist and bacteriologist. They will be integrated into the scientific council of the IHU Méditerranée Infection, where the latter will succeed the first.
These names join the large community of African researchers gathered around the Marseille professor, including the Congolese Jean Akiana, the Marien Ngouabi University of Brazzaville, the Algerian Idir Bitam, the National Veterinary School of Algiers, and which also included the Malian Ogobara Doumbo, who died in 2018. In addition to his former PhD students, these people all consider their peer to be a “big African brother,” with whom he plans to create state-of-the-art laboratories in Guinea-Conakry.
Described as a maverick in the fight against dogmas, familiar with the field but resistant to the beaten path, Professor Raoult does not hesitate to visit the African countryside. “He’s an elephant that likes to come into contact with gorillas,” says Dr. Jean Akiana, director of health technology at the Ministry of Health and a researcher at the National Laboratory of Public Health, from Brazzaville.
Interested in the transmission of bacteria from animals to humans, and vice versa, Didier Raoult also went to meet the gorillas in the Lesio-Louna reserve, in the Pool region, in the south-east of Congo-Brazzaville, to analyze their microorganisms and compare their residues with human stools. “We found picornavirus in the stools of gorillas that are from the same family as coronavirus. Also, if we see Ebola genes in such samples, we can give an early warning,” Akiana says.
Jean Akiana recently received funds from Professor Raoult’s laboratory to visit the Chipounga reserve to see if chimpanzees are the cause of the wild polio virus that struck Pointe-Noire in 2015. The Marseille professor also visited several departments such as Likouala, Sangha and Plateaus to prospect for new microorganisms with no immediate link to an identified epidemic. His samples, examined in Marseille, could be useful when new epidemics occur.
In Algiers, a team of 100% Algerian teacher-researchers is working on the final establishment of a research laboratory. The joint unit based in the Algerian capital is also working on the surveillance of infectious diseases, benefiting from the facilities of the Institute based in Marseille.
Without foreigners, “no science in France”
“Its main objective is to help French-speaking countries, transfer cutting-edge technology and train young researchers in these innovative diagnostic tools,” says Sokhna. But Professor Raoult, on the other hand, also knows very well what his country’s science owes to the African continent. Critical of the French administration’s restrictions on visa deadlines, he believes that today the French scientific community relies primarily on the contribution of PhD students from North Africa and sub-Saharan Africa. During Emmanuel Macron’s visit, the head of state was welcomed by a team of young researchers from Algeria, Morocco, Mali and Burkina Faso.
“In France, 50% of graduate students are foreign. Without foreigners, there would be no French science,” Didier Raoult argued at a conference in 2013. The French researcher then praised the work of the emigrants who are part of his team, the “war machine” of scientific research. “The best, the smartest, the most dynamic, those who work on Sundays—they are only blacks and Arabs. That’s it! That’s the way it is.”
The theme of the conference? “Disobedience at the heart of the research innovation process.” Renowned for breaking free from doctrine and not being concerned about manners, insulted by some, adored by others, Didier Raoult is a divisive character. And he seems to be incurable. “I couldn’t have imagined [my studies] triggering passions of this nature, I don’t even know where they came from,” he says in a video posted online April 8, in which he announces the impending results of his new study, this time with 1,000 patients.
According to the French press, the professor presented Emmanuel Macron on Thursday with his results, which establish a virological cure rate of more than 91%. Accustomed to not being listened to by politicians, who think researchers are “exotic birds,” Professor Raoult says he is “guided by curiosity and exploratory research.” Will he be able to rally Emmanuel Macron to his cause? In a recent Odoxa poll, Raoult the iconoclast is ranked as the second most-favored personality in France.