The global rush to produce vaccines and treatments against Covid-19 cannot be allowed proceed without adequate scientific scrutiny, according to leading immunologist Prof Luke O’Neill.
He was all in favour of “get as many shots on goal as possible” but already there were “stupid studies being published” without being peer reviewed, which was not in the best interests of global public heath.
With 41 potential vaccines, 23 anti-inflammatories and six antivirals in trial "all rushing forward . . . let's not lose our scientific rigour and the standards we have to apply," he told a web conference hosted by Access to Medicines Ireland on how best to ensure rapid development of effective and low-cost medication.
"You can take short cuts a little – it's an emergency – but you have got to apply the bog standards we have for drug discovery and vaccine development," added the scientist based in Trinity College Dublin.
He said clinical trials on hydroxychloroquine, including one in Ireland, were justified, if carefully monitored. A trial conducted by French virologist Didier Raoult, however, was flawed. His big concern was likely heart effects.
He may be a hero in France as "Mr Get-a-fix", anti-big pharma, advocating a drug that is as cheap as chips and appearing on the front of Paris Match magazine, but he remained to be convinced, Prof O'Neill said.
On US president Donald Trump talking up the drug normally used against rheumatoid disease and malaria, he said: "My head goes into my hands whenever he opens his mouth. If I was in America and a scientist I would be hanging my head in shame. We have to be careful here."
The potential of the BCG vaccine had to go through clinical trials but three studies over the past week indicated a trend of reduced deaths in countries with vaccination programmes. The third – from John Hopkins University on Monday – was the strongest yet while acknowledging co-founding factors.
“It could be a non-specific boost against Covid-19. We see it as a bridge to a vaccine,” he said, while stressing those who had the vaccine are not necessarily protected.
Prof Sam McConkey of Royal College of Surgeons in Ireland said re-purposing existing drugs rather than developing new ones is likely to be the quickest route to generating preventative medication; antivirals for those with the disease and for treating acute respiratory distress syndrome in most-seriously ill Covid-19 patients.
Remdesivir, one of the potential therapies furthest along in the development process, was being tested by Gilead Sciences which had produced some of the best HIV drugs, but it had a reputation for charging an awful lot for drugs, he noted.
Hoarding drug supplies
Dr Andrew Hill of the University of Liverpool said insular actions of states had caused bidding wars and meant some countries were hoarding drug supplies at a time when collective action on a global scale was required. This was because supply chains were failing, which meant hospitals in Italy and elsewhere were running out of drugs. "It's a lesson we have got to learn."
Covid-19 demonstrated "it's high time we stop relying on the market mechanism", said Dr Gaelle Kirkorian, who is leading Médecins Sans Frontières' campaign for effective drugs, tests and vaccines to be made available and affordable to people who need them most around the world.
The scenario of “no medication, no vaccine and no ventilators is a disaster for society”, she believed, while the pandemic was causing other product shortages, notably in antibiotics, insulin and reagents, which were also being sold to the highest bidder. This was exacerbated by a limited number of companies controlling the market.