The antimalarial drug chloroquine, and its derivative, hydroxychloroquine, are also candidates for COVID-19 treatments. Researchers first began testing their ability to halt the spread of viruses during the battle against AIDS. The drugs are designed to interfere with "endocytosis," the process by which a virus or other microbe enters a cell. They have since been shown to have some success in the lab against a wide range of viral diseases including the common cold and the SARS virus. On March 16, Chinese public health officials announced that a clinical trial at 10 hospitals in Beijing, Guangdong and Hunan Provinces involving more than 100 patients showed a positive effect—patients who took chloroquine were more likely to show a reduction in fever, showed clearer lungs on CT scans and reduced the amount of time to recover.
More treatments will emerge as doctors and scientists on the front lines continue to try new drugs. For instance, in March, a Chinese official said that the drug favipiravir, developed by Fujifilm Toyama Chemical as an influenza drug, showed positive results for COVID-19 patients in trials in Wuhan and Shenzen.
There are many obstacles to getting a treatment out of the lab and into the hospital. First, clinical trials must show that the drugs work safely, and many drugs typically fail this test. A cocktail of the HIV drugs lopinavir and ritonavir, which were being tested in China, was reported to have no benefit to patients. The effectiveness of HIV drugs against COVID-19 remains largely anecdotal and unproven. And choloquine in high doses can prove toxic.
Once a drug is proved safe and effective, getting it to millions of patients around the world requires a massive manufacturing capacity. Ramping up can take months, says Prashant Yadav, a visiting fellow at the Center for Global Development and an expert on healthcare supply chains. For instance, he estimates it would likely take six months to a year to sufficiently ramp up production to meet the potential global demand for remdesivir, should it prove effective and safe.
Given the urgent need for new drugs around the world, some public health officials have called for new protocols to determine who will decide how to allocate limited supply. There would have to be a way of coordinating the supply of drugs, with clear roles and responsibilities for fast-tracking treatments. This would involve an unprecedented level of coordination among the World Health Organization, organizations that finance global health measures, supply-chain experts in the pharmaceutical companies and governments. Once a country has obtained a drug, the government together with private health care organizations and drug companies have to fast-track distribution of the drugs.
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