2023-04-19 05:08:36
SERIES. The scientific reputation of the IHU has been devastated by the scandals, but it is all Marseille research that is splashed
Episode 2 (Wednesday): how Marseille research has been discredited
Episode 3 (Thursday): the painful return to ethics
Episode 4 (Friday): Pierre-Edouard Fournier, the disciple emancipates
“Expression of concern“. In academic publications, this mention is a stain and sounds like a warning. “Warning, this study may contain errors or be untrustworthy“, warns the publisher. This warning now appears on many IHU studies published by PLOS One, a mega scientific journal with free access on the Net, whose level of requirement is however not very high. Common point to all these articles subject to caution: the name of Didier Raoult always appears in the list of authors.And for good reason, for years, it was the unspoken rule at the IHU: any publication had to be co-signed by its omnipotent director. Today, well beyond the studies around the Covid-19, it is all the work of the scientist at the “3,500 international publications” and his teams which is called into question. The decision of his successor, Professor Edouard Fournier, to suspend as soon as he takes office last September all the clinical trials conducted within the IHU will not have been enough to circumscribe a burnt reputation.
“We are overwhelmed with denunciations from the editors of scientific journals on publications that are sometimes years old!, observes a researcher from the inside. You have to answer well, and while you’re doing that, you’re not doing science. It’s harassment…“. Spurred on by Elizabeth Bik, a Dutch microbiologist, a “commando” of anonymous researchers is sifting through dozens of studies made in IHU. From the misused graph to the slightest comma, “everything is dissected and denounced to all the publishers on the planet, who come back to the authors to explain themselves. In science, there is no prescription“. Foreign universities also receive these letters when one of their researchers has co-authored an article. “They are basically told that they worked with thugs, it does a lot of damage”.
“We have to demonstrate Raoult’s hypothesis”
Because there are thousands of studies produced by the IHU. In its last report of August 2022, the General Inspectorate of Social Affairs (Igas) pointed to a “Run to publication strategy” in low-quality journals. Between 2012 and 2021 no less than 6790 articles were published, an astronomical average of 679 per year: more than two publications per day if we remove the weekends! But quantity is not equal to quality. In this report, interns accuse: “We have to demonstrate Raoult’s hypothesis”, “we are not asked to understand but to obey”, testify of young researchers who have admitted to having “intentionally watered down results or removed things that don’t work so as not to be pressured”.
If the reputation of the infectious disease center has been so devastated, it is not only because of unorthodox methodological “tinkering”, but because of “serious shortcomings” in human trials have been discovered, some of which may fall under “penals sanctions“. It is in these terms that the National Medicines Agency (ANSM) in May 2022, then the General Inspectorate of Social Affairs, in September, crucified the IHU in vitriolic reports. It is a question in particular of “wild” experiments against tuberculosis – 35 patients treated with a cocktail of non-recommended molecules, six of whom had serious complications – or even the absence of informed consent from patients, some of whom were minors or homeless French speakers.
A now decried “Raoult method” that the Marseille professor had defended at the very beginning of the pandemic, favoring a “ethics of treatment” in front of “research ethics”. Raoult, son of a bush doctor, wants to be a field clinician and slays the “academicisms”: in other words the scientific methods that create consensus, from which he exempts himself in the name of his genius.
Here lies the scientific reputation of the IHU…. And the reception, in March 2022, of an “international Covid summit” bringing together at the IHU the most barred figures of conspiracy thinking did not improve the image of the Marseille institute. This is unfortunate for an organization supposed to be the reference for infectiology in France, at a time when the threat of emerging viruses has never been so high. It is also a big shortfall for the AP-HM which, until now, has been reaping the fruits of the “publication race” via the Sigaps points mechanism, a controversial bibliometric tool used in France to calculate part of the annual envelope granted by the ministry to university hospitals. In 2018, Didier Raoult announced “bring in 11 million euros a year”, figure never confirmed by the AP-HM. According to Igas, the IHU weighed over 10 years to “24% of research credits granted to the CHU”.
Today, it is the very survival of the Marseille institute that is at stake. Will the ANSM once again allow clinical research to be carried out? Inspectors from the agency were on a mission in Marseilles at the end of March to judge. In the longer term, the question of renewing the funding of the institute by the State, via the General Secretariat for Investment and the National Research Agency (ANR), will arise. When it was created in 2011, the Marseille IHU obtained the largest grant ever granted to medical research in France (€72 million). Local authorities had donated a total of €150 million. After a first extension of the funding granted in 2019, an international jury will have to give a new opinion soon. “It will be the moment of truth”, ironically a historical opponent of Didier Raoult. It is also time to lay the foundations for a true scientific strategy.
Judicial information opened, two judges seized
Another truth, a judicial one, is also awaited. In Marseille, two investigating judges were seized and a judicial investigation opened on July 4 after two reports from the ANSM. It is a question of establishing whether the IHU has conducted interventional research involving the human person that is unjustified and outside regulatory authorisations. Are targeted a study on a pathogen in the stools and saliva of young children under 5 years old (the samples had taken place during consultation in the emergency room of the North and Timone hospitals) and research on the acquisition of respiratory, digestive and cutaneous carriage of bacteria resistant to antibiotics acquired during stays abroad by health students from Marseille. It is also a question of establishing whether there was forgery in writing and use of forgery: the ANSM having received at the announcement of its inspection a “falsified document concerning an opinion of the internal ethics committee of the IHU” to justify research.
Last September, during the submission of the Igas report, François Braun and Sylvie Retailleau, Ministers of Health and Higher Education, made a new report to the Marseille public prosecutor’s office for “facts likely to relate in particular to illegal interventional research and harassment“. “This report as well as all the annexed documents have been the subject of a detailed analysis with regard to the new facts and those already denounced having been the subject of the opening of a judicial investigation.“, let the prosecution know, “who must soon assess the orientation to be given to these facts“.
The public ministry, which is already overwhelmed with files, has not finished with the settling of scientific accounts. An investigation is also open for cyberharassment, attempted blackmail and extortion of which IHU staff claim to be victims on the part of the administrators of the Pubpeer site who advocate scientific ethics and of which one of the figures is Elizabeth Bik.
At this stage, none of his files have given rise to indictments.
Find Thursday the 3rd episode of our series: “The IHU after Raoult: the painful return to ethics”
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