Africa’s largest clinical trial of potential COVID-19 treatments is underway with participation from 13 African countries and a team of global researchers. The study comes after calls for coronavirus responses better tailored to Africa’s unique health care challenges.
The study aims to identify treatments that can be used against mild and moderate cases of COVID-19 early and prevent spikes in hospitalisation that could overwhelm the continent’s already fragile, underfunded, and overburdened health systems.
The “Anticov” study, as it is called, which also involves Antwerp’s Institute of Tropical Medicine and international research institutions, will be carried out at 19 sites in 13 countries and led by African doctors.
“There is a need for large clinical trials in Africa for COVID-19 to answer research questions that are specific to an African context,” Dr. John Nkengasong, director of the Africa Centres for Disease Control and Prevention, told the Guardian.
He added: “African countries have mounted an impressive response so far to COVID-19 and now is the time to prepare for future waves of the disease. It will help answer one of our most pressing questions: with limited intensive care facilities in Africa – can we treat people for COVID-19 earlier and stop our hospitals from being overwhelmed?”
The study will be an open-label, randomised, comparative, adaptive platform trial (a clinical trial method first pioneered for cancer drugs that allows for simultaneous testing of different treatments) and will test the efficacy of treatments in 2,000 to 3,000 mild-to-moderate patients in Burkina Faso, Cameroon, Côte d'Ivoire, the Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Ghana, Guinea, Kenya, Mali, Mozambique, Sudan, and Uganda.
The idea is to identify treatments that can prevent progression of coronavirus to severe disease and also limit transmission. Being an adaptive platform trial, scientists will be able to make rapid decisions including adding, continuing, or stopping treatment sections based on ongoing analysis of results.
“The Institute of Tropical Medicine in Antwerp, Belgium, has been working closely with its partners in Ethiopia for many years now,” said Johan Van Griensven, from the Institute of Tropical Medicine in Antwerp.
“Together with more than 10 other African countries, we are able to investigate whether COVID-19 patients with mild symptoms who receive early treatment experience less serious complications,” he added. “This strategy is necessary in order not to overburden the fragile health system, as hospitals with sufficient staff and intensive care units are sparse in African countries.”
The Guardian reports that the trials will begin testing against a control arm: the HIV antiretroviral combination lopinavir-ritonavir and the malaria drug hydroxychloroquine, which remains the standard of care for COVID-19 today in numerous African countries.
“It is heartening to see so many African countries collaborate to get much-needed answers about our unique COVID-19 patient needs,” said Dr. Borna Nyaoke-Anoke, senior clinical project manager at Drugs for Neglected Diseases initiative (DNDi), which is also the sponsor for clinical trials in the DRC, Kenya, and Sudan.
She added: “Africa has for the most part avoided the large-scale mortality seen in other countries, but with lockdowns ending and borders opening, we need to be prepared. We need research here in Africa that will inform policies and test-and-treat strategies, so that as clinicians we can give the best options to people with COVID-19.”
Launched in April by seven global partners, the ACT-Accelerator is a unique coalition aimed at accelerating global efforts against the COVID-19 pandemic. Its members are working together to develop tests, treatments, and vaccines as quickly as possible, while also strengthening the world’s most fragile health systems.
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