The product has not been tested in line with international standards, the World Health Organization said this week. Its use could accelerate resistance to an ingredient that has proven effective in treating malaria, heightening risk related to that potentially deadly infection, experimental medicine expert Dr. Arthur Grollman told CNN. Madagascar, where many people rely on natural medicine, has agreed to work with the African Union and the Africa Centres for Disease Control and Prevention on an herbal remedy it claims could help treat Covid-19, the bloc's deputy chairman announced Wednesday in a tweet.The effort would aim to "benefit the continent at large," Kwesi Quartey tweeted.But the World Health Organization, or WHO, has warned against using untested herbal therapies to treat coronavirus patients without first "establishing their efficacy and safety through rigorous clinical trials" in step with global standards. WHO acknowledges medicinal plants such as Artemisia annua, from which the tonic is made, are "being considered as possible treatments" but stresses they "should be tested for efficacy and adverse side effects," it wrote this month in a news release."As efforts are under way to find treatment for COVID-19, caution must be taken against misinformation, especially on social media, about the effectiveness of certain remedies," the agency wrote."Many plants and substances are being proposed without the minimum requirements and evidence of quality, safety and efficacy. The use of products to treat COVID-19, which have not been robustly investigated can put people in danger, giving a false sense of security and distracting them from hand washing and physical distancing which are cardinal in COVID-19 prevention, and may also increase self-medication and the risk to patient safety."
How unproven claims can fuel drug resistance
Madagascar's President, Andry Rajoelina, has put himself front and center in the push for the tonic he calls a preventive and curative remedy against the coronavirus. But he has not detailed how it supposedly treats the virus or discussed potential side effects. His spokeswoman has not responded to CNN's request Wednesday for comment. Along with a photo of himself sipping an amber-colored fluid from a bottle, Rajoelina announced last month that scientists from the country's research institute had developed Covid Organics, or CVO, to treat Covid-19. CNN's calls and emails this week to the Malagasy Institute of Applied Research have not been returned.CVO is made from the artemisia plant and other local Malagasy plants, the president said. The herb is a source of artemisinin, a significant component of modern antimalarials, and the plant has been the subject of Western studies looking at possible coronavirus treatments.But the tonic promoters are drawing erroneous conclusions from unproven claims that artemisinin, much like antimalarial chloroquine and hydroxychloroquine, will work against the coronavirus, Dr. Arthur Grollman, professor of pharmacological science and experimental medicine at Stony Brook University in New York told CNN."The flaw in their thinking is that antimalarial activity has anything to do with antiviral activity, which it does not," Grollman said. Widespread use of Artemisia annua in the pandemic will accelerate resistance to it, endangering people in countries, including Madagascar, where artemisinin-based drugs are being used to treat malaria, he said."The product won't work and will result in more people dying from coronavirus due to the false sense of security created by the advertisement and also more people dying from malaria due to artemisia resistance," Grollman said.Malaria is endemic in many African countries, and as many as 400,000 people died of it globally in 2018, according to WHO.
Independent validation is critical
While WHO recognizes herbal medicine as a resource in the public health systems of many Africa countries, its efficacy must be proven on a case-by-case basis, the agency's director for Africa, Dr. Matshidiso Moeti, said Thursday. "Any medicine that is being used including this product in Madagascar, we advise be taken through some assessment," she said. "How effective it is? … What might be the side effects that may be undesirable? What could be the dosing that needs to be adjusted?" The WHO country office has "initiated" a conversation with authorities in Madagascar to test and assess the tonic, officials said. The race to find a treatment for the coronavirus has reignited interest in antimalarial drugs. Even US President Donald Trump had touted the antimalarial hydroxychloroquine as a potential treatment, though studies since then have shown it doesn't work against Covid-19 and could cause heart problems.Even as researchers the world over work feverishly toward a treatment for Covid-19, no country should simply promote the efficacy of an unproven remedy, said Charles Wambebe, professor of pharmacology at the Tshwane University of Technology, South Africa. Independent validation with appropriate bodies is key, he said. Potential treatments, including traditional medicines, must pass safety, efficacy and quality checks, among other criteria before they can be accepted globally."If you're confident about the clinical and scientific studies you've done, then submit to a regulatory body for revalidation to give it more credibility," Wambebe told CNN.The African Union has asked Madagascar to share technical and scientific data about the herbal infusion for review as leaders across the continent have expressed interest in using the drink, called Covid Organics, or CVO, to fight outbreaks.Madagascar has been giving out the tonic for free, and Equatorial Guinea, Chad and Guinea Bissau have gotten shipments, the island nation's president said. Nigeria said it had received samples of the product from Guinea Bissau and would first test and validate it. "We will not put anything to use in Nigeria without the endorsement of our regulatory institutions," Nigerian President Muhammadu Buhari said in a statement on Saturday.Read More – Source