On the 21st April 2020, the president of Madagascar endorsed a herbal tea as a prevention as well as treatment for COVID-19.
The statement that led to that announcement is summarized below:
{"Tests have been carried out -- two people have now been cured by this treatment," Rajoelina told ministers, diplomats, and journalists at the Malagasy Institute of Applied Research (IMRA), which developed the beverage. "This herbal tea gives results in seven days," he said.}
Following the announcement, there has been mixed national and international responses. Whilst some countries have gone ahead and ordered shipments of the said “remedy”, others are carefully following the trail to make their decisions.
The WHO has recently made a statement regarding the interest in investigating the cure claims of the herbal tea (https://www.aa.com.tr/en/africa/who-to-study-madagascars-drug-to-treat-covid-19-/1840971). While that is being arranged, rumours have it that the president of Madagascar has pulled his country out of the World Health Organisation and encouraging other African nations to follow suit. What is certain however is the fact that Madagascar slammed WHO for rejecting their discovered cure, as due to the fact that its from a poor African country (https://www.aa.com.tr/en/africa/madagascar-slams-who-for-not-endorsing-its-herbal-cure/1836905).
WHO is however, not in doubt as to the interest in assisting Madagascar to investigate the efficacy of the herbal tea for prevention and treatment of COVID-19.
It is to be noted that the fatality of COVID-19 ranges between 0-10% and tends to be more severe in populations where there are old people, those with co-morbidities and also has not hit the African continent in large numbers. According to Wu and McGoogan's estimates based on 72 314 cases from Wuhan, 81% of patients are classified as mild, 14% as severe, and 5% as critical. CFRs in these subgroups are 0%, 0%, and 49%, respectively. Based on these estimates, of 8043 open cases in China, about 377 are in a critical condition and of those 184 will die. Therefore, once all active cases are closed, we might expect the CFR in China to be around 3·85%.
At the time of writing this article, Madagascar just recorded its first death (https://www.aa.com.tr/en/africa/madagascar-records-its-first-coronavirus-death/1844085). This was a 57 yr old man indigenous to the Island.
The process of licencing a drug for cure and or prevention of a disease has to go through a rigorous process of scientific probity, otherwise, we lose the integrity that science affords us to stay safe from harm.
To accept a tea as cure would, therefore, need to go through the formal process. I will attempt to highlight some of the work flow below:
1. Based on the knowledge of the biology of the disease, there is the stage of drug discovery, development
2. Pre- clinical trials in which the compound is undergoes laboratory and animal testing to answer basic questions about safety
3. Clinical research is then carried out, in a multi-staged process; looking for efficacy, dosing, side effects and marketing processes
4. Regulatory bodies then review the evidence; and even at this stage, the drug is cautiously monitored for side effects
5. Safety monitoring continues in what is described as pharmacovigilance
It is therefore premature for a drug that has not been shown to achieve any of the stages enumerated above to be promoted as cure or prevention for COVID-19 and for any disease for that matter!
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