Coronavirus Investigation : in Madagascar, the president defends his miracle cure

For the past two months, Andry Rajoelina has been heavily involved in promoting a traditional beverage presented, without scientific evidence, as a solution to the Covid-19 epidemic.

The scene dates back to April 20. On this day, the Malagasy president, Andry Rajoelina, gives an astonishing demonstration in front of the television cameras: he takes large sips of a herbal tea with medicinal herbs, claiming that it protects and heals Covid-19. Many then take him for an enlightened one. How the Indian Ocean island, famous for its vanilla, its lemurs and its immense poverty, could have found, in the face and with the beard of scientists around the world, the cure for the virus that condemned half of humanity to snap?

At home and abroad, taunts and critics burst out. But “TGV”, as it is nicknamed in reference to its party, Tanora malaGasy Vonona, and even more to its meteoric rise, cannot be dismantled: the herbal tea in question, distributed free of charge by the army, will soon flow freely in working-class neighborhoods and in schools in the capital. Its composition? Authorized information only mentions a mixture comprising a sagebrush species native to China, Artemisia annua, and several plants endemic to Madagascar, including ravintsara, of the same family as camphor trees.

Until this sequence, Andry Rajoelina, forties in his posh manners, was almost unknown on the international scene, if not for having made his country banished from the international community by taking power thanks to the army in 2009. Alternately fashionable DJ, entrepreneur in the display and communication sector, mayor of Antananarivo, repentant putschist, the multifaceted man returned to power by the ballot box in 2018. He is now here -self-proclaimed word of the continent. Did he not say on RFI that his “tambavy” (“traditional remedy” in Malagasy) is disparaged, is it because he comes from Africa? Hero for some, apprentice sorcerer for others, he willingly criticizes the World Health Organization (WHO) and thanks God for having chosen his island. When skeptics demanded scientific proof of the effectiveness of the drink, he drew an official record of the highly enviable epidemic: only one death recorded to date in this country.

How did he come to believe in the virtues of Covid-Organics (CVO), as it was baptized? He himself gave his version of the facts on national television. “I received a letter on March 24 stating that Madagascar has the remedy that could (…) cure the coronavirus”, he said on April 8. The letter was sent to her by a French orthodontist, Lucile Cornet-Vernet, founder of La Maison de l’artemisia, an association created to promote the use of Artemisia annua herbal tea in the fight against malaria.

Antimalarial virtues

This woman in her fifties, who cultivates Artemisia annua in her vegetable garden in the Oise, embarked on this cause in 2012, convinced that this plant can be a solution for the millions of Africans deprived of access to conventional malaria treatments. Hitherto more accustomed to the chic clientele of her Parisian practice than to the common people of the continent, she has woven a vast network of converted doctors, researchers or simple practitioners saved from malaria fever by the daily absorption of the infusion. Concocted from dried leaves, it is true that the virtues of Artemisia annua have been recognized in traditional Chinese medicine for more than a millennium.

At the beginning of the health crisis, Lucile Cornet-Vernet remembers that China had used Artemisia annua for additional treatment during the coronavirus epidemic (SARS-Cov-1) of 2003. By peeling scientific publications, she notes that this approach combining conventional medicine and traditional remedies is once again adopted in China. In mid-March, she adds in her plea, the British journal Nature Plants took a stand for the use of plants which “can save time as a first line of defense” against the virus. Again, Artemisia annua is cited.

Andry Rajoelina is the first head of state to react to the letter addressed by Mrs. Cornet-Vernet to the leaders of the twenty African countries where “artemisia houses” exist. While the letter calls for “confirming the effectiveness of this plant which grows in Africa by rigorous clinical studies in hospitals”, another piece of information holds the attention of the Malagasy president: after China, Madagascar has the largest stocks of Artemisia annua thanks to the company Bionexx, which cultivates it since the mid-2000s to supply the pharmaceutical laboratories of artemisinin with the molecule extracted from the leaves used in the composition of the most widespread antimalarial treatments. In his letter, the French orthodontist assesses the country’s stocks at “1,000 tonnes”.

“We can’t wait”

Andry Rajoelina immediately realizes that there is a “coup” to be played. Between the receipt of the letter and the presentation of the “tambavy”, ready for consumption and packaged in bottles or to prepare yourself with small boxes of herbal tea, it takes barely a month. Twenty-eight days during which researchers from the Malagasy Institute for Applied Research (IMRA) and some industrialists work in secret before the president gives the green light for commercialization. For the sole proof of the effectiveness of the remedy, it is claimed that two patients with Covid-19 to whom it was prescribed are cured.

Across the chain, the distribution of roles is clear. Bionexx provides the dried leaves. ** The company TAF, of the Franco-Greek Panayotis Taloumis, is responsible for putting the herbal tea in sachets. ** Vidzar, which reigns on the rum and spirits market, manufactures the drink, sold in 33 cl or 1 liter bottles. At this point, Ms. Cornet-Vernet’s association has not been in the loop for a long time. “We have passed on the scientific references we have. It stopped there”, said the founder today, before calling for caution: “It is clear that it is impossible to affirm that an herbal tea made with artemisia is curative without having made clinical studies”.

Such studies would require a time limit which Mr. Rajoelina does not have. “We cannot wait, we must act quickly. In a drifting boat, you don’t ask questions about the life jackets, you use them”, he explains afterwards, on May 3, during a program broadcast on the national channel and on his own. Viva private radio.

But for those who are forced to conceal their doubts so as not to displease him, everything is going too fast. Thus, after a first critical position, the Academy of Medicine of Madagascar returns to the ranks. “If CVO is not a medicine but an improved traditional remedy, the Academy does not oppose its use and leaves it to the free appreciation of everyone”, said its president, Marcel Razanamparany, after a meeting with the all-powerful Head of State. Representatives of United Nations agencies are instructed by their coordinator not to make any public comments on the presidential initiative. It matters little that these agencies finance the budget of 20 million dollars (18.45 million euros) mobilized to deal with the coronavirus.

Political whirlwind

As for IMRA – the Malagasy Institute for Applied Research, to which the discoveries of its founder, Albert Rakoto Ratsimamanga, ensured a solid international reputation – it also ended up cutting its microphone. Its director, Doctor Charles Andrianjara, now directs the curious towards the communication service of the presidency. The venerable institution quickly understood that it would have to play finely to get out safely from a whirlwind where politics took precedence over science.

IMRA is however cautious about the healing properties of CVO. When the head of state follows up on statements promising a cure in ten days, the researchers temper. “The CVO is especially recommended in prophylaxis”, slips a member of management. In the information leaflet finally published on May 4, it is just indicated that this “drug” with antiviral properties strengthens “the immune system” and treats “breathing difficulties”. A list of contraindications (renal and hepatic insufficiency, hypertension, pregnancy) and adverse effects (headache, dizziness, nausea, etc.) qualify the initial claims of safety. It appeared in particular that the remedy reacts badly to heat.

In the spirit of “TGV”, the stake is also economical. “Artemisia will change the lives of Malagasy people”, he announced on May 3. One ton of rice brings in $ 350 a ton, artemisia $ 3,000. We are going to cultivate and build factories to produce medicines. We must move quickly so as not to be overwhelmed. Other countries are doing research, but they don’t have the stocks. Pending this agricultural revolution, the export of artemisia is prohibited. Charles Giblain, director of Bionexx, whose production has been requisitioned, commented with diplomacy on his situation: “If it is important for the president, for the country, for Africa, I will make my production available”, assures the chief of the company, which relies on more than 15,000 small farmers to produce 2,500 tonnes of Artemisia annua per year. His words are more vague when asked who, today, pays for his orders: “The State”, he limits himself to answering.

Beginning of success on the continent

The financial package for this project, run under the secrecy of the presidency, has not been revealed. Andry Rajoelina had initially indicated that all the profits would go to IMRA – which took the statute of foundation in 2012. According to our information, it is no longer current. The scheme under discussion would provide for reserving only 50% for the foundation, the other 50% would be paid into a fund specially created to collect this windfall. For whose benefit? Civil society organizations have called for more transparency.

Despite these various gray areas, the herbal tea had a successful start on the continent. On April 29, the government of Equatorial Guinea was the first to send a plane to Antananarivo to receive its cargo. Followed by that of Guinea-Bissau, responsible for delivery to the countries of West Africa. Then those of the representatives of Tanzania and Congo-Brazzaville crossed in their turn the channel of Mozambique. A real ballet. These signs of support for the daring Malagasy president did not, however, prevent most of them from relying on the prudent recommendations of their health authorities before distributing them.

As WHO has stepped up its warnings, Andry Rajoelina is now in the spotlight. The contained evolution of the epidemic on the island is its best ally. That the curve of contaminations will fly away, and the disavowal would be immediate, taking with him the hope and the pride that he had believed, by a happy coincidence and with a huge cheek, to be able to give back to his compatriots.

Original author : Laurence Caramel (lemonde.fr)