WHO To Spearhead Multinational Trial Effort Aimed At Developing A Coronavirus Drug

The World Health Organization has today announced that it would be starting a multi-arm, multi-country clinical trial exercise to develop a treatment for the novel coronavirus infection -induced illness. The effort, which will be launched in different parts of the world, will involve both international and national organizations joining forces to find an effective response to counter this deadly virus. The trial will test several new drugs and drug combinations and try to gauge their efficacy in reducing mortality among the infected patients and, if so, how much time it would take form the administration of such medicines to the ultimate recovery of the patient. The trial process which has been named as SOLIDARITY already has ten participants signed up- France, Iran, Norway, Thailand, Argentina, Bahrain, Canada, South Africa, Spain and Switzerland. The WHO Director-General, Tedros Adhanom Ghebreyesus, while making the announcement also stated that he is hopeful that more countries will join this trial process in the near future.

The trials, which will be for four set of already licensed drugs and drug combinations, will involve testing these combinations on patients in as many countries as possible to collect large and geographically varied samples which will help gather evidences with a much stronger base to determine the merits and demerits of each of these drugs and drug combinations. Ana Maria Henao-Restrepo, who heads the Research and Development unit of WHO’s “Blueprint” group, while elaborating on the process of the trials stated that the process has been designed deliberately to be as simple as possible. The process, which can be implemented even in the smallest and the most overloaded hospitals, will evaluate these four therapeutic combinations on multiple parameters like time spent by a patient in a hospital, need for ventilator support and intensive care before the trial data is compiled in each individual country and sent to the organization for interpretation.

The trail effort is relevant for many reasons. Since the start of the pandemic in China, the country has been working tirelessly to contain the same and has been employing all possible drug and drug combinations to treat the infected patients achieving varying degree of success. However, the data collected by the health officials in China from these efforts have not been done in a controlled environment. Though Chinese doctors have stated that they have seen good results from many of these drugs, but the sample sizes are too small to accept these results as confirmation of the efficacy of these drugs. Moreover, due to the emergency-like situation in China, there must have been several discrepancies and omissions in the data collection process, making them less relevant for a proper clinical trial process. The WHO’s initial trials will be more elaborate and spread over a wider territory. It will not have many of the weakness that the Chinese data has. Moreover, conducting the trials over a wider geographical area will give additional data regarding the behaviour of the drugs on different geographical and climatic conditions.

The four candidates of drug and drug combinations that are going to be tested by the WHO are: antiviral drug Remdesivir, a combination of HIV drugs lopinavir and ritonavir, combination of lopinavir, ritonavir and interferon beta and the antimalarial drug chloroquine. There is already some evidence on the efficacy of these drugs from animal testing in a controlled environment, with further studies required to strengthen the conclusions. The above medicines are widely available, with Remdesivir being manufactured by American company Gilead Sciences Inc and Lopinavir and Ritonavir being combined and sold by AbbVie Inc of America again under the brand names Kaletra. These trials, however, do not take into account several other proven and under-trail therapeutic drugs that hold the potential for being effective against this present strain of the coronavirus. The developers of the formulations will have to conduct trials at their own cost to prove the efficacy of these medicines before they can be made available to the general public.

Since the occurrence of the previous two pandemic outbreaks related to SARS and H1N1, a significant amount of research has taken place to understand the coronavirus and ways and means of defeating it. Several research teams around the world are also working round the clock to develop vaccines that could protect against the virus infection. However, much of the research work being done now has a few more years to run before anything concrete can come out of it, which can then be implemented on a mass scale. The trial process of WHO, thus, is aimed at finding immediate solutions which can help check the spread of this virus which has been causing mass hysteria and in the past two months and has brought most of the business activity in the world to a grinding slowdown.

The efforts being made by WHO is this regard is a welcome move. The organization has taken the initiative to bring on board as many countries as possible to coordinate the fight against this pandemic. Till now, most of the countries have been putting in individual efforts to fight this virus and international travel ban, quarantine and lockdown-type measures have only been partially effective in containing the spread of this epidemic. Should more countries come out, join hands with WHO in this effort and pool their resources, a swift and effective resistance to the pandemic is a possibility. This will also serve to a be an example to deal with any future public healthcare threat, should it come knocking on our doors.

There is one other major problem with the current response mechanism to counter this epidemic that has come to light and which needs immediate attention. The time taken for a successful diagnosis of the virus infection is long; in many countries, it takes more than a day before test results can confirm if a patient is infected. This time lag does not only delay the treatment process but is also responsible for a less than effective response to contain this pandemic. South Korea has been able to develop a diagnosis process where positive cases can be identified within hours; should the WHO make efforts to make this process available to all other countries it will prove to be a very powerful tool in checking the spread of this virus.