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No WHO bar on India testing HCQ as preventive

Topics Covered: Issues related to health.

No WHO bar on India testing HCQ as preventive

What to study?

For Prelims: What is HCQ? What is it used for?

For Mains: Its efficacy in treating COVID 19, concerns associated and way ahead.

Context: World Health Organisation’s (WHO) recently announced moratorium on testing hydroxychloroquine (HCQ), the controversial anti-malarial drug, for treating COVID-19.

However, it has now clarified that the moratorium doesn’t imply that India should pause testing the drug as a preventive.

What you should know?

HCQ was one of four drug-combinations being tested in a global clinical trial, called Solidarity Trial, coordinated by the WHO.

Under this, four hundred hospitals in 35 countries would be comparing the benefits to COVID patients from taking either Remdesivir; Lopinavir/Ritonavir; Lopinavir/Ritonavir with Interferon beta-1a; and hydroxychloroquine.

They are all drugs for other diseases but have shown varying degrees of promise in blunting COVID-19 infection.

How are these tested?

To objectively assess the benefit of these drugs over standard-of-care treatments, clinicians would be assessing these drugs in Randomised Clinical Trial (RCT) — the most medically legitimate approach — whereby some groups of patients, unknown to the administering doctors and recipient patients — would get the drug and some wouldn’t.

Why has hydroxychloroquine been considered as a possible treatment for the coronavirus?

  1. A promising laboratory study, with cultured cells, found that chloroquine could block the coronavirus from invading cells, which it must do to replicate and cause illness. However, drugs that conquer viruses in test tubes or petri dishes do not always work in the human body, and studies of hydroxychloroquine have found that it failed to prevent or treat influenza and other viral illnesses.
  2. Reports from doctors in China and France have said that hydroxychloroquine, sometimes combined with the antibiotic azithromycin, seemed to help patients. But those studies were small and did not use proper control groups — patients carefully selected to match those in the experimental group but who are not given the drug being tested.
  3. Another reason the drug has been considered for coronavirus patients is that it can rein in an overactive immune system, which is why it is used to treat lupus and rheumatoid arthritis. In some severe cases of Covid-19, the immune system seems to go into overdrive and cause inflammation that can damage the lungs and other organs.

Is HCQ really effective in treating COVID 19?

Some studies have shown that HCQ shows no benefit — in fact, it puts patients at greater harm.

  1. The latest such study published in the medical journal Lancet found that in 96,000 hospitalised SARS-CoV-2 patients across six continents, there was no benefit — even additional harm of cardiac arrhythmia — in those being treated with HCQ.

India’s arguments:

  1. India recommends the drug as a preventive for groups that were at high risk of contracting the infection. It is based on internal studies and laboratory experiments that showed the drug had anti-viral properties.

Which countries authorised their use?

USA, Brazil, France and several Middle Eastern countries.

InstaThink:

Prelims Link:

  1. What is Chloroquine?
  2. Which countries have approved the use of HCQ?
  3. Types of coronaviruses which affect humans?
  4. Name of the virus that causes COVID 19.
  5. What is Kawasaki disease?

Mains Link:

Several countries have recommended the use of HCQ in treating the COVID 19 disease. How effective is this in the absence of a vaccine? Discuss.

Sources: the Hindu.