Madagascar’s claims about clinical trials for herbal coronavirus cure creates confusion

Madagascar's President Andry Rajoelina this week announced the start of clinical trials of an injectable solution based on extracts of the artemisia plant, a herbal treatment the Malagasy leader has been promoting for treatment of Covid-19.

The trials were said to be supported by the scientific committee of the World Health Organisation's Madagascar branch, although claims about artemisia trials were later contradicted by the presidency itself, while the WHO distanced itself from the comments. 

“There's already major clinical trials taking place in the US of an artemisia-based injection remedy. This remedy already exists, we will use it. It's already been discussed with the WHO,” said Rajoelina, during a visit on Tuesday to Toamasina, the capital of the Atsinanana region on the east coast. 

“Madagascar's received all the necessary authorisations in the eyes of the scientific committee to be able to carry out clinical trials here too,” Rajoelina added, according to Sarah Tétaud, a correspondent in Antananarivo. 

Rajoelina has been promoting the use of artemisia to treat the coronavirus, promising to deliver Covid-Organics, a Malagasy concoction based on the medicinal plant, to several African countries. He also recently agreed to send artemisia-based products to the Caribbean. 

Artemisia is not without merit -- a South African researcher recently launched a crowdfunding initiative to help finance clinical trials of both Artemisia annua and Artemisia afra, two species of the plant, to help determine their effectiveness against Covid-19. 

A derivative of one of the plant's compounds is also used as part of a combined drug malaria treatment, but there are concerns that using artemisia on its own could encourage antimalarial drug resistance. 

Nevertheless, the World Health Organisation at the start of May told RFI that they were yet to receive any data from Madagascar about the Covid-Organics product and its effectiveness against Covid-19. 

Contradictions 
Madagascar's presidency somewhat backtracked over claims about starting an artemisia clinical trial, describing a misunderstanding by the media about what Rajoelina was saying. 

“In fact, there's confusion, maybe the media didn't understand what the president intended to announce,” Michelle Sahondrarimalala, director of legal studies at the presidency, told RFI's Service Afrique. 

Sahondrarimalala described different guidelines for the treatment of Covid-19 and a third protocol recently launched. 

The first protocol uses chloroquine and azythromycine as a combined treatment as inspired by controversial French doctor Didier Raoult, Sahondrarimalala told correspondent Tétaud. This treatment does not form part of a clinical trial in Madagascar since both these drugs have already been used for treatment of other diseases, according to the Malagasy official. 

“The second protocol concerns Covid-Organics, the improved traditional remedy, developed on the basis of WHO guidelines for clinical studies of traditional medicine in Africa,” Sahondrarimalala added, referring to the artemisia herbal tea Rajoelina has been promoting. 

An injectable form of an artemisia-based treatment had yet to be developed by the Malagasy Institute of Applied Research or national pharmaceutical research centre, said Sahondrarimalala. “Because you mustn't forget that as soon as Covid-Organics is transformed into an injectable form, it is no longer considered an improved traditional remedy.” 

No injections of artemisia 
The third protocol, which is the one involved in clinical trials, is a combined treatment for Covid-19 patients, said Sahondrarimalala. It is based on two drugs, in injectable form, already on the market and used therapeutically, she added. However, this has nothing to do with the Covid-Organics product. 

Sahondrarimalala would not reveal the name of the two drugs being used in this clinical trial, since this would be up to the research team, the scienitific committee, “but it's not artemisia, there's no artemisia,” she said. 

These comments from an official within Madagascar's presidency appear to directly contradict Rajoelina's announcement about clinical trials on an injectable artemisia-based product. The World Health Organisation said “nothing was validated” in terms of norms or international standards for clinical trials, Tétaud reported.