We could know within two weeks whether Professor Didier Raoult, the French virologist who heads the Mediterranean infectious and tropical disease institute in Marseille, will go down in history as the man who saved the world from Covid-19, or will be dismissed as an arrogant, misguided scientist who raised false hopes.
Raoult administered a cocktail of hydroxycloroquine, a less toxic derivative of chloroquine, used to treat malaria, lupus and rheumatoid arthritis, and azithromycin, an antibiotic used against bacterial pneumonia, to 24 Covid-19 patients.
After receiving 600mg of Plaquenil (one of the commercial names for chloroquine) and 250mg of azithromycin for six days, three-quarters of patients tested negative for the virus, while 90 per cent of the control group who did not take the drugs still tested positive.
On February 25th, Raoult spoke of Chinese experiments with hydroxycloroquine in a video titled "Coronavirus: endgame!" He hastily conducted his own clinical study and revealed the results in a second video on March 16th.
US president Donald Trump apparently learned of Raoult's experiment through a Twitter post by the billionaire entrepreneur Elon Musk. On March 20th, Trump wrongly claimed in a White House press briefing that the US Food and Drug Administration had approved what he called "the very powerful" drug chloroquine to treat Covid-19.
Trump was corrected by Dr Anthony Fauci, a top expert on infectious disease and a pillar of the fight against coronavirus. But Trump persisted, tweeting the following day that "HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine."
As reported in this newspaper on Monday, Brazil's populist president Jair Bolsonaro ignored warnings from the health regulator and ordered the army to step up the production of chloroquine.
Pharmacies in west Africa, where chloroquine has been used for decades to treat malaria, saw a run on the drug. The government of Morocco purchased the entire stock of chloroquine produced by the French pharmaceutical giant Sanofi in Casablanca. Some French hospitals are administering Plaquenil out of "compassion" for the families of Covid-19 patients.
Christian Estrosi, the mayor of Nice who has tested positive for Covid-19, "wants to trust" Raoult. Conservative senator Bruno Retailleau is exhorting the government to prescribe it more widely in French hospitals. Petitions supporting Raoult are circulating on the internet.
The scientific community is divided. Raoult tested the drugs on a very small number of patients.
"For the moment, there is no proof of the efficacy of this molecule on the disease, either for prevention or as treatment," Dr Thierry Vial, head of a pharmacological centre in Lyon told, Le Figaro. "We have only preliminary data, which is encouraging and should be followed up, but is insufficient for systematic treatment of the illness."
Solid base
“One cannot administer treatment without a solid basis, especially not chloroquine, which is not an ordinary medicine,” said Bernard Bégaud, professor of pharmacology at the University of Bordeaux.
Pressure on the French government is such that health minister Olivier Véran announced at the weekend that chloroquine will be tested, with three other drugs, on 3,200 patients in the EU’s scientific programme Discovery, which is seeking a cure for Covid-19.
Véran said he wants to know if Raoult’s study “can be repeated on a bigger scale in other hospitals, by independent teams”. This was necessary, Véran said, because “Never has any country in the world given authorisation for treatment on the basis of a study like this”.
Véran also warned the public not to get their hopes up.
“The history of viral disease is strewn with false good news, disappointments and reckless risks,” Véran said.
Wariness of Raoult derives from his unconventional appearance, and from his reputation as a maverick. The television channel LCI described the hirsute professor as looking like “a druid in the Astérix comic books”.
Raoult, age 68, was born in Senegal, where his father was a French military doctor. He moved to Marseille at age nine, joined the merchant navy at age 18, earned a literary baccalaureat at 20 and then went to medical school.
Raoult shares a certain arrogance with Trump and Bolsonaro.
“In my field, I am a star, worldwide,” he boasted to La Provence newspaper.
“I don’t give a damn what others think. I am not an outsider. I’m streaks ahead of the others.”
Like Trump and Bolsonaro, he is also a climate change denier.
Yet millions of people are placing huge hopes in Raoult’s study. A high-ranking French civil servant, now retired, who is following the story closely, believes professional rivalry is interfering with the search for a cure.
Raoult “is unanimously recognised by leading professors” but “annoys the establishment”, the source says. The fact that Raoult forced the French government to include chloroquine in European clinical tests “proves the strength of his de-Gaulle-like conviction”.
