The Lancet casts doubt over hydroxychloroquine study

The Lancet casts doubt over hydroxychloroquine study
In a statement, the medical journal acknowledged “important” questions over the research. (File/AFP)
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Updated 03 June 2020

The Lancet casts doubt over hydroxychloroquine study

The Lancet casts doubt over hydroxychloroquine study
  • Its publication last month triggered the WHO to announce it was pausing clinical trials of the drugs
  • France was among the countries to also halt COVID-19 treatment with hydroxychloroquine

PARIS: The Lancet has issued an “expression of concern” over a large-scale study of hydroxychloroquine and chloroquine it published that led to the World Health Organization suspending clinical trials of the anti-viral drugs as a potential treatment for COVID-19.
In a statement, the medical journal acknowledged “important” questions over the research, after dozens of scientists issued an open letter last week raising concerns about its methodology and transparency around the data, which was provided by the firm Surgisphere.
“Although an independent audit of the provenance and validity of the data has been commissioned by the authors not affiliated with Surgisphere and is ongoing, with results expected very shortly, we are issuing an Expression of Concern to alert readers to the fact that serious scientific questions have been brought to our attention,” The Lancet said Tuesday.
While an expression of concern is not as severe as a journal withdrawing a published study, it signifies that the research is potentially problematic.
The observational study looked at records for 96,000 patients and concluded that treatment with hydroxychloroquine, which is normally used to treat arthritis, and chloroquine, an anti-malarial, showed no benefit and even increased the likelihood of patients dying in hospital.
Its publication last month triggered the WHO to announce it was pausing clinical trials of the drugs.
France was among the countries to also halt COVID-19 treatment with hydroxychloroquine.
It has whipped up fresh controversy over hydroxychloroquine, which has been endorsed by public figures including US President Donald Trump despite concerns over its side effects and a lack of evidence that it is effective.
The study’s authors, led by Mandeep Mehra of the Brigham and Women’s Hospital in the US, looked at data from hundreds of hospitals between December and April and compared those who received treatment with a control group.
It followed numerous smaller studies that suggested hydroxychloroquine is ineffective in treating COVID-19 and might even be more dangerous than doing nothing.
But in an open letter last week, a group of scientists raised “both methodological and data integrity concerns” about it.
These included a lack of information about the countries and hospitals that contributed to the data provided by Chicago-based health care data analytics firm Surgisphere.
While The Lancet corrected a discrepancy in data from Australia, the authors said they stood by their findings and announced an independent review.
But concerns over the underlying data continued, and this week the New England Journal of Medicine also issued an expression of concern over another study using the Surgisphere database that looked at cardiovascular drugs and COVID-19.
Among the most outspoken critics of The Lancet study has been Marseille-based professor Didier Raoult, whose own work has been at the forefront of promoting hydroxychloroquine and has also been subject to criticisms over methodology.
But other critics, like Francois Balloux of University College London, raised concerns over the way the study was conducted, even though they are skeptical the drugs themselves would work as a treatment for COVID-19.
Peter Horby, professor of emerging infectious diseases and global health at Oxford University said the controversy should spark “serious reflection” over the quality of the peer review process.
“Scientific publication must above all be rigorous and honest. In an emergency, these values are needed more than ever,” he said.
He added, however, that decisions to halt trials on the basis of an observational study were “completely unjustified.”
A spokesman for the WHO last week said a comprehensive review of the drugs was expected to reach a conclusion in mid-June.


Indian protests growing as ‘anti-farm’ peace offer nixed

Updated 03 December 2020

Indian protests growing as ‘anti-farm’ peace offer nixed

Indian protests growing as ‘anti-farm’ peace offer nixed
  • New laws ‘could leave farmers landless, at mercy of corporate players’

NEW DELHI: Farmers’ protests across the Indian capital New Delhi have gained momentum as several new groups joined from various parts of the country on Wednesday.

Protesters repeated their demands for the government to scrap new agricultural laws which they say could destroy their livelihoods by opening up the sector to private players.

However, Prime Minister Narendra Modi’s government argues that the laws passed in September would allow farmers to be self-sufficient by setting their prices and selling produce directly to private firms, such as supermarket chains.

Farmers are not buying that and say that the new laws would instead pave the way for the government to stop buying the crops at guaranteed prices, leaving them at the “mercy of private buyers” fixing prices.

Bhanu Pratar Singh, president of the Indian Farmers’ Association, said: “Our basic demand is that the government gives us in writing that the Minimum Support Price (MSP) that the government gives to farm produce should be codified in law in the farm laws.”

Protests escalated last week when tens of thousands of farmers marched to New Delhi, with a majority saying that the new laws would also allow traders to stockpile grains, which they fear will lead to rising prices and more profit for traders amid the coronavirus pandemic.

The demonstrations led to clashes with police, who used tear gas, water cannons and batons against protesters.

Farmers sell their products at wholesale markets owned by the government, which also sets the MSP for grains.

All of that could change with the entry of new market players in the agricultural sector, where individual market prices could supersede the MSP, Jagjit Singh Dalewal of the Indian Farmers’ Union, a joint forum for 30 farm unions, told Arab News.

“It will leave us at the mercy of the big business houses. We don’t want that uncertainty,” he said.

“The traditional market system and the MSP have sustained farmers in Punjab and Haryana for a long time. They assured us a guaranteed price which is higher than the market. The new farm laws deprive us of that,” Dalewal added.

On Tuesday, talks between officials and the farmers’ union failed after the latter rejected an offer to establish a committee on the issue.

A joint statement released by farmers’ groups said that they found the offer “an attempt to buy time without addressing the real issue.”

The next round of talks is expected to begin on Thursday.

“Most of the farmers in India have small landholding, and they cannot compete with the big corporate houses,” Sunil Pradhan, a farmer based in Greater Noida, a suburban city of Delhi, told Arab News.

“A farmer having less than two hectares of land cannot have bargaining power with the corporate groups. He will succumb to pressure and become a pawn in the hands of the big players. Such farmers need government protection,” he added.

The government says that the new laws are not “anti-farmer.”

“The new agricultural law implemented by the government is not anti-farmer at all,” Information and Technology Minister Ravi Shankara Prasad said on Wednesday.

“Under this bill, the safety net of the MSP will remain and will also add new options that the farmers have. Farmers will be able to enter into direct agreements for sale of food grains with production companies,” he tweeted on Wednesday.

Economists have questioned the claims, drawing attention to the “genuine” concerns of farmers.

“Many small farmers are worried that the free market in the agriculture sector will dispossess many small farmers of their lands, which will become corporatized, and they will become landless,” New Delhi-based Prof. Arun Kumar of Jawaharlal Nehru University, told Arab News.

“The government is not doing enough to address the existential concerns of the farmers,” he added.

Kumar said that “86 percent of the farmers are small farmers and cultivate less than 2 hectares of land.”

He added: “They generate a small income, and fear that the new laws will not give them the right kind of prices and that they will become landless laborers.”

Most of the farmers have camped along the Delhi border for the past week and refuse to move to a designated protest site allocated by the government.

“We have been protesting since September in Punjab, but the government has been ignoring us. Now we are at the gate of Delhi and suddenly the government is desperate to engage us for talks,” Punjab-based farmer Sarwan Pandher told Arab News.

According to one estimate, more than 50,000 farmers are camping in different borders of Delhi, with medical professionals sounding the alarm over a possible spike in coronavirus cases due to the large gatherings.

“I blame the government for playing with the lives of the people. They should understand the gravity of the pandemic and address the farmer issue urgently,” Dr. Harjit Singh Bhatti of Progressive Medicos and Scientists Forum told Arab News.