2023-05-31 11:05:28
Did Didier Raoult co-author one study too many? Sixteen learned societies and leading scientific figures, including the president of the French Academy of Sciences, Alain Fischer, consider that the latest study, comparing hydroxychloroquine with other treatments in over 30,000 Covid-19-positive patients, constitutes an unauthorized therapeutic trial – an experiment carried out outside the administrative and ethical rules governing research involving humans. In an article published in The worldthey express their astonishment at the lack of reaction from administrative, regulatory and judicial authorities since the trial went online in early April.
Following their prodding, the French National Agency for the Safety of Medicines and Health Products (ANSM) seems to agree with the op-ed signatories’ analysis of the irregular nature of this study, as does the office of Health Minister François Braun, which sees it as “a further breach of ethical and professional conduct.” After the ANSM in 2021, the ministers of health and research referred the matter to the courts at the beginning of September 2022, following a damning report by their general inspectorates on certain practices of the Institut Hospitalo-Universitaire (IHU) Méditerranée Infection. The referral might be extended to include this new study.
If it hadn’t been for the determination of a number of learned societies, concerned regarding the infringement of best practice and ethics in clinical research, Raoult’s umpteenth snub to the scientific method might as well have gone unchallenged. It’s time to think regarding how to avoid this kind of error in the future.
There’s no denying the efforts made in recent months to get the IHU back on track, notably under the leadership of the new head of Assistance Publique-Hôpitaux de Marseille (the city’s public health establishment) and the IHU’s long-standing institutional partners: Raoult’s retirement, a change of presidency at the IHU Foundation, a new director and compulsory training in clinical research ethics and professional conduct.
Medical populism
But many of Raoult’s supporters, who owe their careers to him, are still in their posts and co-authored the incriminating study. He himself retains an office in the building and has no intention of relinquishing an ounce of his influence. Ideally placed to seriously test the efficacy of hydroxychloroquine versus a placebo, the microbiologist has stubbornly refused to do so, dismissing the evidence that runs counter to his intuition and pushing his anti-system approach to the extreme.
At a time when the government is announcing the creation of 12 new IHUs and four bioclusters, we must draw all the lessons from this Marseille example: Science can benefit from being represented by flamboyant personalities with innovative ways of thinking. But it is important to reflect on sound principles of governance and checks and balances.
While it was Covid-19 that made Raoult a public figure, the IHU’s dysfunctions were already apparent. Hadn’t the National Center for Scientific Research and the National Institute of Health and Medical Research withdrawn their accreditation in 2016 and 2019 respectively from an institute that was destined to be France’s flagship for infectiology? The pandemic exacerbated this drift, as Raoult chose to thrive on an unprecedented form of medical populism, addressing patients directly in his weekly video preachings, impervious to the judgment of his peers. Legal action is needed to remind him that he is not above the law.
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