While debate rages in France over Professor Didier Raoult's recommendation of a mixture of chloroquine (an antimalarial) and azithromycin (an antibiotic) to treat patients with Covid-19, some African countries have taken it very seriously. Such is the case in Cameroon, which has embraced the French professor's method of treatment.
Despite having authorised treatment in a very restricted manner for serious cases, France has shown scepticism regarding a dual therapy combining chloroquine (an antimalarial), or its derivative hydroxychloroquine, and azithromycin (an antibiotic used for lung and ENT infections and angina) to treat patients suffering from Covid-19. On April 22, France's Health Minister Olivier Véran said the most recent publications from clinical studies were not in favour of the dual therapy. Six days later, during a speech on Frances strategy for lifting its Covid-19 lockdown, Prime Minister Édouard Philippe clearly reaffirmed the government's position: “To date, no treatment has proven effective.”
The debate surrounding the protocol of Dr Didier Raoult, the director of the University Hospital Institute (IHU) Méditerranée Infection in the southern city of Marseille, continues to divide the countrys medical community. But while some French professionals consider the treatment too toxic and doubt its effectiveness, many African countries, already accustomed to anti-malarial drugs, have decided in favour of the reseacher and professor. This is notably the case in Cameroon, which has adopted Raoult's dual therapy.
Although the country increased its knowledge of epidemics following the appearance of Ebola in the region, its medical capacities remain limited and a European-style scenario, with a multiplication of serious Covid-19 cases, could lead to a catastrophe. In mid-March, as the epidemic began to spread across Cameroon and European countries, already hard hit, launched lockdown plans, the first video of Raoult selling the effectiveness of his protocol was widely shared on Cameroonian social networks, raising great hopes. In a country where part of the population still has major difficulties in accessing healthcare, the prospect of a treatment based on accessible, inexpensive and familiar drugs appeared to be a blessing.
A chloroquine treatment
On March 27, in a memorandum from Cameroons Ministry of Health, the countrys scientific council proposed the widespread use of chloroquine treatment. Judged “promising”, the treatment could make it possible to reduce viral load and contagiousness, even if the group of scientists acknowledged a “lack of conclusive data”. Finally, the council wished to combine the treatment, as recommended by Raoult, with azithromycin to avoid the risks of secondary infections. On April 9, the protocol was validated for the management of all types of patients with positive Covid-19 tests, from asymptomatic cases to patients suffering from severe infections.
“With the arrival of the first cases, the clinicians were tempted to try the protocols themselves, and it was necessary to give clear instructions quickly to organise the response,” explained Dr Alain Etoundi, director of the fight against disease, epidemics and pandemics at Cameroons Ministry of Health, to FRANCE 24.
“The question of the supposed toxicity of chloroquine has been addressed and dismissed by the council. So far, the results that are coming to us seem satisfactory, but the evaluation of the treatment is ongoing,” he said.
A national hero
Professor William Ngatchou is a cardiovascular surgeon at the General Hospital in Douala, the economic capital of Cameroon. When FRANCE 24 asked him if he had heard of Professor Raoult, he responded with amusement: “Everyone knows Professor Raoult in Cameroon! Some even consider him like a national hero.” Like many health professionals in the country, Ngatchou thinks that the effectiveness of dual therapy combining an antimalarial and an antibiotic has been proven: “Its been almost two months that this protocol has been in use for patients with Covid-19. I myself have noticed significant improvements in patients with its use, and the debate about the side effects of chloroquine seems very exaggerated to me.”
Seven weeks after the detection of the first Covid-19 case on Cameroonian soil, there are more than 2,050 confirmed cases in the country. The progress of the virus seems, as in many African countries, to be much slower than indicated by scientific modelling. Nevertheless, Etoundi asserted that treatment is only one element of a global health policy and it is far too early to claim victory: “We are in a phase where the disease is on the rise and the peak has not yet been reached. Anything is still possible.”
Supply problems and a black market explosion
Beyond a public health resolution, the choice of dual therapy represents a logistical challenge in Cameroon. For while chloroquine was massively used in the country at one time, it has been several decades since it lost its effectiveness in the fight against malaria and was replaced by other, more effective drugs. “Stocks were totally exhausted, we had to place large orders abroad and restart national industrial production," explained Etoundi.
In Cameroon, public hospitals have been selected to centralise Covid-19 patients. In theory, stocks of chloroquine and azithromycin are sufficient there, although a source within medical services, contacted by FRANCE 24, reported occasioRead More – Source