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Saturday, 4 July 2020

WHO’s Conflict of Interest?

By David Macailwain
Pompeo Meets Ghebreyesus 2e5bb
Last week the French National Assembly convened an inquiry into the “genealogy and chronology”  of the Coronavirus crisis to examine the evident failures in its handling and will interview government ministers, experts and health advisors over the next six months. While we in the English-speaking world may have heard endless arguments over the failures of the UK or US governments to properly prepare for and cope with the health-care emergency, the crisis and problems in the French health system and bureaucracy have been similar and equally serious. Given the global cooperation and collaboration of health authorities and industry, the inquiry has global significance.
Judging by the attention paid by French media to the inquiry, which comes just as France is loosening the lock-downs and restarting normal government activities, it is set to be controversial and upsetting, exposing both incompetence and corruption.
Leading the criticism of the Macron government’s handling of the crisis are the most serious accusations that its prohibition of an effective drug treatment has cost many lives, a criticism put directly to the inquiry by Professor Didier Raoult, the most vocal proponent of the drug – Hydroxychloroquine. At his institute in Marseilles, early treatment with the drug of people infected with Sars-CoV-2 has been conclusively demonstrated to reduce hospitalization rates and shorten recovery times when given along with the antibiotic Azithromycin, and consequently to cut death rates by at least half.
Raoult has pointed to the low death rate in the Marseilles region of 140 per million inhabitants compared with that in Paris of 759 per million as at least partly due to the very different treatment of the epidemic in Marseilles under his instruction. The policies pursued by local health services there included early widespread testing for the virus and isolation and quarantining of cases, aimed both at protecting those in aged care and in keeping people from needing hospitalization with the help of drug treatments.
It incidentally seems quite bizarre that some countries – notably the US, UK and Australia, are only now embarking on large testing programs – and claiming a “second wave” in cases – which Raoult calls a “fantasme journalistique”. The consequent reimposition of severe lock-downs in some suburbs of Melbourne, and in Leicester in the UK is a very worrying development.
The efficacy of HCQ and Azithromycin is well illustrated – one should say proven – by this most recent review of its use on 3120 out of a total of 3700 patients treated at the Marseilles hospitals during March, April and the first half of May. Unlike the fraudulent study published and then retracted by the Lancet in May, the analysis in this review is exemplary, along with the battery of tests performed on patients to determine the exact nature of their infection and estimate the effectiveness of the drug treatment. The overall final mortality rate of 1.1% obscures the huge discrepancy in numbers between treated and untreated patients. Hospitalization, ICU, and death rates averaged five times greater in those receiving the “other” treatment – being normal care without HCQ-AZM treatment – equivalent to a placebo.
The IHU Marseilles study and its discussion points deserve close scrutiny, because they cannot be dismissed as unsubstantiated or biased, or somehow political, just because Professor Raoult is a “controversial figure”. There is a controversy, and it was well expressed by Raoult in his three hour presentation to the inquiry. His criticisms of health advisors to government include conflicts of interest and policy driven by politics rather than science. Raoult has been vindicated in his success, and can now say to those health authorities “if you had accepted my advice and approved this drug treatment, thousands of lives would have been saved.”
This is quite unlike similar statements in the UK and elsewhere, where claims an earlier imposition of lock-down would have cut the death toll in half are entirely hypothetical. As Prof. Raoult has also observed, the progress of this epidemic of a new and unknown virus was quite speculative, and its handling by authorities has failed to reflect that. In fact, one feels more and more that the “response” of governments all around the world has followed a strangely similar and inappropriately rigid scheme, of which certain aspects were de rigueur, particularly “social distancing”.
There seems little evidence that would justify this most damaging and extreme of measures to control an epidemic whose seriousness could be ameliorated by other measures – such as those advocated by Raoult’s Institute – which would have avoided the devastating “collateral damage” inflicted on the economy and society in the name of “staying safe”.
Prof. Raoult’s vocal and consistent criticism of the political manipulation of the Coronavirus crisis is hardly trivial however, to be finally excused as a “failure”- to impose lockdowns sooner, to have sufficient supplies of masks or ventilators, or to use more testing and effective contact tracing. What lies beneath appears to be, for want of a better word, a conspiracy.
As previously and famously noted by Pepe Escobar, French officials seemed to have foresight on the potential use of Hydroxychloroquine as a treatment for COVID-19 infection, with its cheapness and availability being a likely hindrance to pharmaceutical companies looking to make big profits from new drug treatments or vaccines. Of even greater significance perhaps, was the possibility – or danger – that the vast bulk of the population might become infected with the virus and recover quickly with the help of this cheap drug treatment, while bypassing the need, and possibly interminable wait for a vaccine.
Now it can be seen that in Western countries the demand for a vaccine is acute, and the market cut-throat, despite assurances from many quarters that “vaccines must be available to all” and that “manufacturers won’t seek to profit” from their winning product. (the profit will naturally be included in what their governments choose to pay them) The clear conflicts of interest between health officials, public and private interests make such brave pronouncements particularly hollow. Just one case is sufficient to illustrate this, as despite its unconvincing performance in combatting the novel Coronavirus, the drug developed and promoted by Dr Anthony Fauci and company Gilead, Remdesevir, was rapidly approved for use following a research trial sponsored by the White House.
More concerning however is what appears to be a conflict of interest in the WHO itself, possibly related to the WHO’s largest source of funding in the Gates organization. While the WHO has not actively opposed the use of Hydroxychloroquine against the virus infection for most of the pandemic, neither has it voiced any support for its use, such as might be suggested by its obvious benefits, and particularly in countries with poor health facilities and resources.
Had the WHO taken at least a mildly supportive role, acknowledging that the drug was already in widespread use and there was little to lose from trying it against COVID-19, then it is hard to imagine that those behind the recent fabricated Lancet paper would have pursued such a project. Without claiming that the WHO had some hand in the alleged study that set out to debunk HCQ treatment, it should be noted that the WHO was very quick to jump on the non-peer-reviewed “results” and to declare a world-wide cancellation of its research projects on the drug. And while it had to rescind this direction shortly afterward when the fraud was exposed, the dog now has a bad name – as apparently intended.
This stands in sharp contrast to the WHO’s sudden enthusiasm for the steroidal drug Dexamethasone, recently discovered by a UK research team to have had a mildly positive benefit on seriously ill COVID19 patients:
“The World Health Organization (WHO) plans to update its guidelines on treating people stricken with coronavirus to reflect results of a clinical trial that showed a cheap, common steroid could help save critically ill patients.
The benefit was only seen in patients seriously ill with COVID-19 and was not observed in patients with milder disease, the WHO said in a statement late Tuesday.
British researchers estimated 5,000 lives could have been saved had the drug been used to treat patients in the United Kingdom at the start of the pandemic.
“This is great news and I congratulate the government of the UK, the University of Oxford, and the many hospitals and patients in the UK who have contributed to this lifesaving scientific breakthrough,” said WHO Director-General Tedros Adhanom Ghebreyesus in the press release.”
There is something more than ironic in the WHO’s interest in a different cheap and available drug that has also been widely used for decades, but which is no use in protecting those people in the target market for the vaccine. To me, and surely to Professor Raoult and his colleagues, this looks more like protecting ones business interests and investor profits, at the expense of public health and lives.
Postscript:
It has just been announced that GILEAD will start charging for its drug Remdesevir from next week at $US 2340 for a five-day course, or $US 4860 for private patients. Generic equivalents manufactured in poorer countries will sell for $US 934 per treatment course. Announcing the prices, chief executive Dan O’Day noted that the drug was priced “to ensure wide access rather than based solely on the value to patients”.
It seems hardly worth pointing out that six days treatment with Hydroxychloroquine costs around $US 7, so for the same cost as treating one patient with Remdesevir, roughly four hundred could be given Hydroxychloroquine. If this is compounded by the effective cure rate, Remdesevir treatment costs closer to one thousand times that of HCQ. The addition of Azithromycin and Zinc doubles the cost of HCQ treatment, but also increases its efficacy considerably.

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