SANDF soldiers in Mary Fitzgerald square in Newtown Johannesburg. Picture: Alaister Russell
SANDF soldiers in Mary Fitzgerald square in Newtown Johannesburg. Picture: Alaister Russell

A local pharmaceutical company has received permission from the medical regulator to import half a million chloroquine phosphate tablets for use in severely ill Covid-19 patients.

Austell Laboratories, which is based in Parktown in Johannesburg and describes itself as the largest privately owned pharmaceutical company in the country, said this week it will donate 50,000 of boxes of 10 tablets to the department of health for state use.

Working with Austell, the department of health applied to the SA Health Products Regulatory Authority for special emergency permission to import the drug from a new Indian supplier – and was quickly granted it.

Chloroquine is being used by doctors globally in the treatment of extremely sick Covid-19 patients, though it is not yet known how effective it is. It has been used in the official guidelines for treatment in China, South Korea and SA. 

At last count, SA had 709 confirmed cases of Covid-19, ahead of a shutdown which takes effect on Thursday March 26 at midnight. Experts expect the real number of individuals with the virus to be multiples of that. Chloroquine has been touted, prematurely, as a miracle cure, but there has not been enough testing on its use to counter Covid-19.

About 80 % of Covid-19 cases are mild, according to the World Health Organisation (WHO), with those patients recovering through resting at home without medical treatment or chloroquine, which, experts say, can interfere with the heart’s electrical activity. 

Specialist physician and Wits infectious disease fellow Dr Jeremy Nel helped draw up the chloroquine treatment guidelines for SA. 

“The evidence for using chloroquine in Covid-19 is weak, although [human] studies at least have appeared promising,” Nel tells the FM.    

“For hospitalised patients or those with risk factors for severe disease, we suggest considering a short course of chloroquine, pending further data.”

The problem, says Nel, is that stock of the drug is limited – nationally and internationally. “As you can imagine, many countries are suddenly interested in procuring the drug, and access is expected to be difficult.”

The tablets will arrive in the nick of time. India is reducing many exports as it is under lockdown to prevent the coronavirus spreading in the heavily populated and crowded nation.

But Gani says the order will be delivered to SA. “Any order that was placed and paid for before the Indian lockdown on March 24 will be delivered.”

Chloroquine, also known as chloroquine phosphate, was once used to prevent and treat malaria before widespread resistance to the drug developed. It is currently used in the treatment of lupus, an autoimmune disorder, and by some people with rheumatoid arthritis.

 But this hasn’t stopped some people from punting it as the answer to the crisis.  US President Donald Trump, for one, tweeted that the drug is “one of biggest game-changers in the history of medicine” and has spoken of it as a possible cure.

He said: “Why should we be testing it in a test tube for a year and a half when we have thousands of people that are very sick and we can use it on those people and maybe make them better?”

But after Trump’s comments, an Arizona couple took a nonmedical form of it used in fish tanks to kill parasites. The man died, but his wife survived. Two Nigerians have also been treated for chloroquine poisoning after taking it at home in an attempt to prevent contracting Covid-19.

 This is partly why the US Centers for Disease Control & Prevention (CDC) warns people against using it at home and the use of it by those with liver disease and kidney failure. 

Last week, Dr Anthony Fauci, head of the US National Institute of Allergy & Infectious Diseases, publicly contradicted Trump and explained that support for the drug is “anecdotal”, and scientific studies have yet to be completed.

At the same televised conference in which Trump promoted chloroquine, Fauci said “we’re trying to strike a balance” between proceeding with a potential treatment, while sticking to a protocol that “would give us information to determine if it’s truly safe and truly effective”.

Nonetheless, chloroquine is being officially trialled in New York as a treatment of severely ill Covid-19 patients.

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