Hydroxychloroquine, Remdesivir: "we need to redefine" patient interest ".

  • L'Opinion | by: Peter J. Pitts |
  • 04/27/2020 12:00 AM
Hydroxychloroquine, Remdesivir:
The Covid-19 poses a multitude of scientific and technical questions that concern scientists, regulators and medical researchers. A key issue must however be actively discussed within civil society. Who should have priority access to therapies, including the vaccine (when available)? Who will define the "essential" groups and the individuals of the first rank? And who will make these decisions?

Are you essential if you are a caregiver? What about the police and firefighters? And of those who work in supermarkets and more generally in the food chain? There are other ways to think about the meaning of the word "essential". Should we give priority to the oldest patients? Or the children? And what about those in poor health? This is clearly a highly subjective subject depending on whether you take into account employment, age or health history. What about where you live? Should the developed world be treated first? What about the ability to pay? The positions depend on where you stand.

Another difficulty stems from access to repackaged and experimental drugs. It is instructive to see how the healthcare world (largely influenced by patient voices) has handled these types of issues in the past. It is enough to study the history of AIDS. The virus was identified as potentially fatal in 1981. As early as 1982, it was clear that it was spreading across the globe, killing everyone it infected. Like today, AIDS patients developed pneumonia and respiratory infections.

"Billions of people around the world have used hydroxychloroquine in the past 65 years, so there is no problem"

"Parallel line".  After harshly and actively confronting the FDA, the United States drug agency, and the National Institutes of Health, the national activists, AIDS activists forced the acceleration of the authorization for circulation of AZT in 1987. This first drug showed an ability to slow the progression of AIDS. Under an accelerated marketing authorization, drugs that have shown efficacy in the first clinical trials may be approved.

But AIDS activists wanted to broaden the assessment to other potential drugs beyond those selected for clinical trials. In 1990, they collaborated with Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Allergies and Infectious Diseases, to put together a plan called a "parallel line" . Under this system, patients could be given medication if they were unwilling or unable to participate in a standard clinical trial.

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