Some veterans of the Australian Defence Force have criticized a new study testing the effectiveness of antimalarial medication as a COVID-19 prophylaxis, which uses soldiers as test subjects.
A small selection of soldiers from the ADF will be given a range of doses of the antimalarial drug chloroquine to see whether it can really stop, or slow, the spread of COVID-19.
A number of Army veterans fear the study could both endanger soldiers and potentially lead to misleading results because many soldiers may be inclined to initially downplay side effects.
A select group of soldiers from the Australian Defence Force will be asked to participate, under informed consent, in a study on the effects of chloroquine as a COVID-19 treatment
‘One of my primary concerns with these proposed trials is that there will be a degree of coercion placed on exactly the people who will be at the front line of our response to the COVID-19 pandemic,’ Major Stuart McCarthy said in an ABC News report.
The study, which passed an ethical review from the ADF’s Malaria and Infectious Diseases Institute, will also use frontline healthcare workers who volunteer to serve as subjects using the government’s standard informed consent rules.
In an email announcing the study, the ADF’s surgeon general Sarah Sharkey argued the study would be safe, pointing to the fact that chloroquine has been used by over a billion people since it was first developed in 1934.
Moreover, the seriousness of the COVID-19 pandemic required the government to try and explore every possible avenue for treatment and prevention that it can.
‘Well controlled trials are urgently needed given the profound global impacts of this disease,’ Sharkey wrote.
Major McCarthy, who is medically retired from service, was a test subject in an earlier set of Army studies in the late 1990s and early 2000s, when the Army investigated the safety of other antimalarial drugs, including mefloquine and tafenoquine.
Steven Scally was a medical officer in the ADF during earlier studies of antimalarial medicines in the late 1990s and 2000s, and says the long term health consequences from those still haven’t clearly been documented
Major Stuart McCarthy was a subject of one of the earlier ADF studies on mefloquine and tafenoquine, and worries soldiers will feel pressured to not just participate but to downplay potential side effects
Those studies, according to ABC, left many veterans struggling with lingering health conditions, including psychosis, anxiety, depression, and memory loss.
Steven Scally was an Army medical officer during those trials and says that even today the exact relationship between the drugs and long-term side effects isn’t fully understood.
‘We are nowhere near getting to the bottom of what’s happened with trials that were conducted many years ago, so I just don’t think the Australian Defence Force has an established reputation at all for conducting any sort of medical research at all,’ Scally said.
In her email, Sharkey dismissed comparisons between chloroquine and mefloquine, noting they are derived from different sources and have substantially different effects.
The ADF’s surgeon general Sarah Sharkey addressed safety concerns of the new trial in an email announcing its approval, pointing to the fact that chloroquine has been widely used on more than a billion patients since it was first discovered in 1934
Pharmacologist Andrew McLachlan of the University of Sydney says that while chloroquine is a familiar medicine, there’s still uncertainty about its effects at higher dose ranges, which is part of what the new study will hope to observe.
‘It is a medicine we have a lot of experience with over really decades of treatment, but like any medicine it does carry some risks, particularly at higher doses,’ Andrew McLachlan said.
‘Finding the right dose will be absolutely critical, and that’s why trials at the moment will be starting with the recommended current doses but potentially exploring a range of doses to see how effective this treatment might be.’
While Scally doesn’t dispute the need for further study, he remains unconvinced that using soldiers as test subjects is the best way to about it.
‘Pretty much at the time of enlistment, upon taking the oath, you exchange free will for obedience and that is a culture that really has to exist for the purpose of carrying out your role as a soldier or a sailor or an airman to defend the country,’ he said.
‘I don’t think it’s the role of the ADF to offer up its personnel and human resources to be used as guinea pigs for a drug trial.’
WHICH COUNTRIES HAVE ALREADY APPROVED CHLOROQUINE TO TREAT PATIENTS?
Medicine regulators in the US have approved the use of antimalarial drugs chloroquine and hydroxychloroquine in patients with severe cases of COVID-19.
Doctors across the States can now prescribe the medicines to patients who are critically ill with the virus.
They were granted emergency approval by the Food & Drug Administration (FDA) on March 30.
Doctors in Spain and Italy – the two worst-affected European countries -have already been told they can prescribe the drugs as a last resort.
In the UK, meanwhile, doctors have been instructed not to use the drugs, which can also treat rheumatoid arthritis and lupus, except in clinical trials.
The British Government has banned wholesalers from exporting the drugs to different countries, showing it is protecting the UK supply, but has not yet approved its widespread use because of a lack of evidence.
The drug has been used in China throughout the outbreak and doctors have reported good results, but they have not been published in robust scientific trials.
South Korea was also among one of the first countries to start using it, and there have been reports of doctors in the Netherlands giving it to COVID-19 patients.
In France, a team led by Professor Didier Raoult at a hospital in Marseille reported last week that they had carried out a study of chloroquine on 36 COVID-19 patients.
The World Health Organization has launched a worldwide trial called SOLIDARITY, involving scientists in countries all over the globe, to test which drugs work well on COVID-19 patients – chloroquine and hydroxychloroquine are included in this.