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Statement on the Madagascar COVID-19 cure

The advent of COVID 19 and its virus SARS-CoV2 has brought up a number of issues including the desire to find a cure urgently.  Somehow the pressure for solutions has brought on board all spheres of people who are usually not directly active in the issues of medicine and disease treatment. Of note, we have witnessed various comments and statements on traditionally scientific information being handled by politicians often much to the chagrin of professionals in those fields. 

The World Health Organization (WHO) has been tasked by nations of the world as the watchdog for global health issues like pandemics.  As such, most countries respect and accept the information from WHO as authentic, unbiased, and in the best interest of the global community.  Therefore, in this era of political leaders’ enthusiasm for health issues as concerns for their citizens rise, the world also looks to WHO for guidance as often as needed.  Notwithstanding its shortcomings, real or perceived, it is still in our interest to heed their advice.

THE MADAGASCAR CASE:

On the 20th of April 2020, the president of Madagascar Andry Rajoelina made headlines around the world in various media houses when he announced that Madagascar has found the cure for COVID-19.  This medicine is called COVID-organics and was touted to be both preventative and curative for the Covid-19. At that point, it had apparently already cured 2 people and according to Lova Hasinirina Ranoromaro, the president’s chief of staff, the medicine had been tested on a sample of 20 patients  over a period of three weeks (“Coronavirus: Caution Urged over Madagascar’s ‘herbal Cure’ – BBC News” n.d.) (“COVID-Organics: Madagascar Launches Africa’s First Cure for Virus | Africanews” n.d.) The research and tests on the medicine were carried out at  Malagasy Institute of Applied Research (Imra) led by Dr. Charles Adrianjara, the Director-General of Imra(“Coronavirus: Caution Urged over Madagascar’s ‘herbal Cure’ – BBC News” n.d.).

This medicine is actually a herbal tea that is supplied in dried form or ready to drink fluid.  The exact ingredients of this infusion have not been fully divulged but it is said to contain the herb Artemesia annua as the main ingredient, but with other herbs (“Madagascar’s President Promotes Unproven Herbal Cure for COVID-19” 2020).  Following its launch, the president ordered it to be given freely to all, and schools could reopen provided the students took the drink(“Covid-19 in Madagascar: The President’s Controversial ‘Miracle Cure’” 2020).

There have been dissenting voices from the scientific community including the National Academy of Medicine Madagascar (NAMM) which objected to referring to COVID-organics as medicine but rather as an improved herbal drink as well as a caution on the use of an untested substance on wide population against their will (Ranaivoson 2020). It is claimed that the remedy has contributed to the increase of recoveries in Madagascar and the reduction in the viral spread. Other countries like Tanzania and Guinea Bissau have since shown an interest in procuring some of the herbal drink for their own population(News n.d.)(“Coronavirus: Tanzanian President Promises to Import Madagascar’s ‘cure’ – BBC News” n.d.). 

A concern has been raised by both the WHO and the Africa Center for Disease Control (CDC) on the claims of this remedy. The CDC has invited Madagascar to subject its remedy and related ingredients for peer review and evaluation to ascertain the validity of the claims (“COVID19: African Union in Discussions with Madagascar over Herbal Remedy | African Union” n.d.).

ANALYSIS:

  1. As the Adventist Health Ministries Department, our position on health in general, and on the use of remedies that are put into the body in whichever avenue, is that all practices and remedies must be evaluated on whether they are in line with the Bible, the Spirit of Prophecy(SOP) and evidence-based medicine.  
  2. COVID-19 is a novel virus disease and as such there are still many unknowns with new discoveries of the trajectory of the disease found literally daily. Worldwide there are teams working on all manner of research to find ways to fight this scourge, including vaccines, medicines, etc. Since this is a novel virus, necessarily it is not mentioned by name in the Bible or the SOP, thus our evaluation of the recommended treatment practice will be on the principles of interpretation and on evidence-based medicine.
  3. It is our understanding that the Madagascar remedy has as the main ingredient Artemisia annua, also known as qinqhao, sweet wormwood, sweet annie, sweet sagewort, annual wormwort or wormwood (“Artemisia Annua” 2020). Its picture is shown below. This is an ancient Chinese herb on record since more than 2000 years ago for the treatment of fever, other body discomforts and in later years (the 1970s) found effective against Malaria(“Artemisinin | Drug” n.d.)(Dalrymple, n.d.).
  4. The Imra in Madagascar is an old institution that has produced some acknowledged herbal medicine. It was established in 1956 and has been set to preserve traditional remedies and collaborate internationally to get the best out of both worlds where medicines are concerned.  It has been working with A. annua since it was introduced to Madagascar in 1975 for the treatment of Malaria(“Madagascar’s ‘COVID-Organics’ Born from Local Traditional” 2020).
  5. Since the outbreak of corona related diseases in China, Chinese researchers and other teams have been working on the potential use of artemisia derivatives since it was observed that there was some promise of relief for COVID-19 patients when anti-Malaria drugs like chloroquine and anti-HIV drugs were used. Some groups started working on these tests since the advent of SARS in early 2000  (“Artemisia Annua to Be Tested against COVID-19 | Max-Planck-Gesellschaft” n.d.)
  6. There are a number of researches published and ongoing for the use of A.annua for treatment of other conditions like arthritis, cancer, and some other parasitic infections. Many of these are still at the research stage and not open for general public consumptions(Bilia et al. 2014)(Mesa et al., n.d.).
  7. There have been some concerns with side effects and other complications reported with the use of the A. annua remedies, of note is ototoxicity- inflammation of the ear leading to possible deafness in severe cases. Also, hepatitis and dermatitis have been reported.  Concerns of resistance formation in malaria treatment from the prolific use of A. annua as monotherapy have been raised(“Artemisia Annua | Memorial Sloan Kettering Cancer Center” n.d.). 
  8. With limited subjects tested on for the remedy, there are concerns about dosing for the right level of treatment. Getting the right concentration of Artemisia derivatives is an ongoing challenge as the active ingredients appear to be affected by dissolving in water(Ferreira, Zheljazkov, and Gonzalez 2013).
  9. Madagascar indeed has a low number of those infected by Covid-19 as of 5/5/2020 it has 151 tested positive with 101  recovered and no mortality. But it is not unique to this as Sub-Saharan Africa at large has had to date low prevalence (there are many suggestions as to reasons for this including lack of testing in many places).  The Covid-19 seems to move in waves as such no conclusions can be drawn on the African prevalence. As for Mortality, the case of Rwanda is noted who have more cases than Madagascar, 261, and no mortality either with 129 recoveries.  La Reunion has 424 cases, 300 recovered, and no mortalities. Uganda has 98 cases, 55 recoveries, and no fatalities (“Coronavirus Update (Live): 3,722,692 Cases and 257,896 Deaths from COVID-19 Virus Pandemic – Worldometer” n.d.).

In view of the above points, it is acknowledged that people taking the COVID-organics herbal tea of Madagascar, may have some medicinal effect that could affect the users positively or negatively depending on the quantity and the state of health of the user. However, as indicated, this remedy has not been sufficiently tried for Covid-19. Tests only showed some promise but were never proven reasonably effective.

Covid-19 is a new and evolving disease, it will be unfortunate to take it lightly and expose people to the disease with the belief of some untested protection. Thus, we would strongly counsel our members not to neglect the tried and tested methods of prevention. It is noted that Madagascar still continues to encourage social distancing, use of masks, and hand-washing as the first line of defenCe from the coronavirus. Sentiments that the Madagascar treatment is not being considered because it comes from Africa are unfortunate. It is hoped that having demonstrated that there are African medicines peer review mechanisms that have been started, we will all await the verdict from relevant professionals. Hitherto we wish to uphold the precaution of the WHO not to jump to conclusions on any remedy until it has been proved useful by relevant bodies.

May those contemplating taking this remedy also note that the active ingredients have also been shown to give side effects that may leave one debilitated even though they may not get infected with Covid-19.  So the normal precautions of ingesting chemically active substances should still prevail; first, do no harm, take remedies that are proven to add value to your body not introduce possible destruction.Finally, as the SID Health Ministries, we note that this particular remedy has not passed the bar of evidence-base yet, and thus we do not recommend it for Covid-19, be it for prevention or treatment.  But we note that we can only advise, our members can now make informed decisions on this matter.

By DR. Sikwa

SID Health Ministries Director

WORKS CITED

Artemisia Annua.” 2020. In Wikipedia. https://en.wikipedia.org/w/index.php?title=Artemisia_annua&oldid=953502644.

“Artemisia Annua | Memorial Sloan Kettering Cancer Center.” n.d. Accessed May 6, 2020. https://www.mskcc.org/cancer-care/integrative-medicine/herbs/artemisia-annua.

“Artemisia Annua to Be Tested against COVID-19 | Max-Planck-Gesellschaft.” n.d. Accessed May 5, 2020. https://www.mpg.de/14663263/artemisia-annua-to-be-tested-against-covid-19.

“Artemisinin | Drug.” n.d. Encyclopedia Britannica. Accessed May 5, 2020. https://www.britannica.com/science/artemisinin.

Bilia, Anna Rita, Francesca Santomauro, Cristiana Sacco, Maria Camilla Bergonzi, and Rosa Donato. 2014. “Essential Oil of Artemisia Annua L.: An Extraordinary Component with Numerous Antimicrobial Properties.” Review Article. Evidence-Based Complementary and Alternative Medicine. Hindawi. 2014. https://doi.org/10.1155/2014/159819.

“Coronavirus: Caution Urged over Madagascar’s ‘herbal Cure’ – BBC News.” n.d. Accessed May 5, 2020. https://www.bbc.com/news/world-africa-52374250.

“Coronavirus: Tanzanian President Promises to Import Madagascar’s ‘cure’ – BBC News.” n.d. Accessed May 5, 2020. https://www.bbc.com/news/world-africa-52519853.

“Coronavirus Update (Live): 3,722,692 Cases and 257,896 Deaths from COVID-19 Virus Pandemic – Worldometer.” n.d. Accessed May 6, 2020. https://www.worldometers.info/coronavirus/.

“COVID19: African Union in Discussions with Madagascar over Herbal Remedy | African Union.” n.d. Accessed May 5, 2020. https://au.int/en/pressreleases/20200504/covid19-african-union-discussions-madagascar-over-herbal-remedy.

“Covid-19 in Madagascar: The President’s Controversial ‘Miracle Cure.’” 2020. France 24. May 5, 2020. https://www.france24.com/en/20200505-covid-19-in-madagascar-the-president-s-controversial-miracle-cure.

“COVID-Organics: Madagascar Launches Africa’s First Cure for Virus | Africanews.” n.d. Accessed May 5, 2020. https://www.africanews.com/2020/04/22/covid-organics-madagascar-launches-africa-s-first-cure-for-virus//.

Dalrymple, Dana G. n.d. “Artemisia Annua, Artemisinin, ACTs and Malaria Control in Africa: The Interplay of Tradition, Science and Public Policy,” 183.

Ferreira, Jorge F. S., Valtcho D. Zheljazkov, and Javier M. Gonzalez. 2013. “Artemisinin Concentration and Antioxidant Capacity of Artemisia Annua Distillation Byproduct.” Industrial Crops and Products 41 (January): 294–98. https://doi.org/10.1016/j.indcrop.2012.05.005.

“Madagascar’s ‘Covid-Organics’ Born from Local Traditional.” 2020. The Africa Report.Com. May 1, 2020. https://www.theafricareport.com/27203/coronavirus-madagascars-covid-organics-born-from-local-tradition/.

“Madagascar’s President Promotes Unproven Herbal Cure for COVID-19.” 2020. Mongabay Environmental News. April 20, 2020. https://news.mongabay.com/2020/04/madagascars-president-promotes-unproven-herbal-cure-for-covid-19/.

Mesa, Luz Estella, Pierre Lutgen, Ivan D Velez, and Angela M Segura. n.d. “Artemisia Annua L., Potential Source of Molecules with Pharmacological Activity in Human Diseases,” 15.

News, A. B. C. n.d. “Madagascar’s President Touts Herbal Drink against COVID-19.” ABC News. Accessed May 5, 2020. https://abcnews.go.com/International/wireStory/madagascars-president-touts-herbal-drink-covid-19-70378591.

Ranaivoson, Garry Fabrice. 2020. “Covid-Organics – L’ANAMEM revoit sa position.” L’Express de Madagascar (blog). April 25, 2020. https://lexpress.mg/25/04/2020/covid-organics-lanamem-revoit-sa-position/.

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