President Donald Trump says the US could completely cut economic links with China. AFP/SAUL LOEB
US President Donald Trump’s scooping up of the world’s entire supply of remdesivir, one of few proven Covid-19 treatment drugs, has brought South Africa’s own desperate quest for a cure to a screeching halt.
South Africa is one of more than 70 countries participating in the solitary trial by the World Health Organisation (WHO), a multiarm randomised control trial comparing several experimental treatments for Covid-19.
But the country’s leg has failed to take off due to the shortage of the drug. The Trump administration has reportedly struck a deal and bought up more than 500 000 doses of the nucleotide analogue prodrug, which, according to The Guardian, is all of US pharmaceutical manufacturer Gilead’s production for July and 90% of August and September.
“One of the key drugs, remdesivir, has been allocated by [Trump] … for priority use within the USA, so this drug is harder to get than many others at the moment,” Dr Jeremy Nel, coprincipal investigator with Professor Helen Rees at the University of the Witwatersrand, said yesterday.
“Due to chronic shortages of remdesivir, we have sadly been unable to start yet.”
The US National Institutes of Health ran a large clinical trial on remdesivir and found that it was able to cut recovery time for hospitalised Covid-19 patients by about 30%, or four days. The drug was approved for use in Europe last week and European governments are now in urgent talks with Gilead to get access to it.
Trump’s move to “nationalise” the Gilead production has drawn criticism from many quarters, with critics saying it perpetuates the gulf between rich and poor nations when it comes to drugs. Nel said some of the WHO solidarity test drugs have arrived in SA but, unfortunately, those which had arrived, such as hydroxychloroquine, have recently been dropped by Solidarity.
According to Nel, an infectious diseases specialist at Helen Joseph Hospital in Johannesburg, hydroxychloroquine was dropped from the trial after two large, well-designed trials found no benefit when it was used to treat patients with Covid-19. He explained that Solidarity was trying to help identify the drugs or drug combinations that work best for the treatment of Covid-19.
“Although initially Solidarity included hydroxychloroquine as one of its components, this component was dropped last month after it appeared that the drug wasn’t helping patients.
“Although there’s always the possibility that new evidence will come to light, at this point, at least, it doesn’t appear to work,” Nel said.
Once they have consented to the trials, Nel said Covid-19-infected patients would be enrolled at 14 selected academic hospitals in the country. The treatment duration would depend on which arm of the study they were randomly allocated to, but typically it would be for up to 14 days.
“The hospitals were chosen with two key criteria in mind. They had to be big academic hospitals with experience doing trials rapidly and efficiently; and we wanted to make sure the trial sites were distributed widely throughout SA, rather than just being from one province,” Nel said.
He said the trial itself would run until clear answers were obtained on whether the drugs being tested are working and that it is expected to last several months. Gilead unveiled a remdesivir price of $390 (about R6,600) per vial – or $2 340 per patient for a typical five-day treatment course.
What is remdesivir
– siphom@citizen.co.za
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