On testing the two pre-existing anti-malarial drugs that could help safeguard healthcare workers, scientists and healthcare providers around the world are set to become the new subjects for these clinical trials.

The drug trial will include 40,000 doctors and nurses across Asia, Africa, and Europe who will receive chloroquine or hydroxychloroquine which are both older anti-malarial drugs, as noted by Science.

Drug trials

Despite one malaria researcher, Matthew White calling the trial an 'incredibly difficult' and 'bureaucratic process' the trial will begin this month. The drugs will be used in a strategy now linked with HIV prevention called pre-exposure prophylaxis (PrEP).

Randomized participants from Asia will be given chloroquine or a placebo for three months while participants in Europe and Africa will receive hydroxychloroquine.

White, who is based at Mahidol University in Bangkok told Science that, "in fragile health care systems, if you start knocking out a few nurses and doctors, the whole thing can collapse. So we realized that the priority would be to protect them."

Participants are required to submit a report on their temperatures using an application or a website, which the researchers will analyze those who are symptomatic and asymptomatic in addition to the severity of symptoms.

The attraction of testing these drugs, in particular, is the fact that they are potentially readily deployable en masse on a timely basis and scientists already know an awful lot about them, said White.

Not to deploy yet

Despite initial evidence that they may be effective, researchers have also been cautious in deploying these drugs. A decrease in the supply could affect those people's access to the drugs, since people with other conditions rely on the drug to treat rheumatoid arthritis and lupus.

The same drugs are run under a concurrent study in Africa, North America, and Europe by the Bill and Melinda Gates Foundation. Separate studies are also ongoing in the United States, Australia, Canada, Spain and Mexico.

The researchers also considered testing nitazoxanide which is a different preventive drug typically used as an anti-parasitic drug as well as an anti-body rich serum made from people who have recovered from the virus.

Jeremy Farrar, head of the Wellcome Trust, who is funding White's efforts told Science that if there was a drug that could prevent infections that the healthcare workers could take, then that would be an enormous public health benefit.

Some are not waiting for the new trials

Although most experts do not recommend using the two anti-malarial drugs yet until it is proven effective in safeguarding the healthcare workers, some countries are not waiting for the new trials.

For instance, India has already recommended hydroxychloroquine for healthcare workers that are caring for COVID-19 patients as well as the patients' household members. Bangladesh has also a similar policy. This disqualifies them for the test trial according to White.

As many scientists say, there is no basis for recommending the drug. White added that the premise that it is better to recommend the two drugs than do nothing at all is untrue because it could be worse than nothing.

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