'Red tape' holds up antiviral pill that could help fight Covid-19

An antiviral pill, which has been found to shorten Covid-19 infections by up to a week, is being sold to governments around the world by two businessmen trapped in SA by travel restrictions.

Kempton White, Samuel Dayani and Jake Willis Fleming, airborne-pollutant experts who run a company called InfraSalience, were on the road between Johannesburg and Mossel Bay reviewing their air-cleaning technology facilities and prospective new sites when the virus struck.

Now they have based themselves in the Karoo. From there, they are promoting the medication - also available in what they claim is a more effective form under the trade name Avigan - to global health officials as an emergency pandemic intervention.

The drug, which costs about $650 (R11,400) per patient, has shown success against Covid-19 in Japan and China, and more countries are importing supplies.

Others are waiting for data from more clinical trials across the globe, coordinated by the World Health Organisation. Avigan has been approved by Japan's ministry of health since 2014.

Zhang Xinmin, director of the China National Centre for Biotechnology Development, went public on favipiravir this week, saying clinical trials in Wuhan and Shenzhen involving 340 people had provided positive results, shortening the infection by up to seven days and easing symptoms.

White, the founder of InfraSalience - which specialises in turning carbon dioxide from toxic emissions into pharmaceutical-grade baking soda that can be used in pill manufacture - said SA should consider rolling out the drug.

But the health department, like other countries, is taking a cautious approach. Spokesperson Dr Lwazi Manzi said: "The minister [Zweli Mkhize] has indicated that we are monitoring all the research coming through with all the various clinical trials of various medicines and vaccines."

Favipiravir was used in the fight against ebola in the Democratic Republic of Congo (DRC), and experts suspected it could fight Covid-19 in the same way by halting replication of RNA (ribonucleic acid).

This means that once the virus is inside a host cell, it cannot duplicate its own genetic material.

Dr Richard Kaszynski, co-founder of the Stanford Solutions team at Stanford University in the US - which aims to make health care more equitable worldwide - was senior medical adviser to the DRC in 2019 during an ebola outbreak. "We had experimental vaccines, but we had nothing for post-exposure prophylaxis to protect health workers, or the family of the sick," he said.

In January, his team was using favipiravir when whispers of a "strange virus in China began to emerge".

Kaszynski said: "Before we left Africa, researchers had concluded that a novel coronavirus was the cause. The penny dropped instantly and we were excited because we knew favipiravir targets the same [protein] found across a broad spectrum of RNA viruses, including coronavirus.

"The growing body of evidence supporting our theory, combined with a demonstrated safety profile, makes favipiravir an excellent candidate. The drug can easily be taken at home and should prevent disease progression at the individual level but also help curb the spread of the virus in the community. The drug 's potential use as a prophylactic is another point to consider."

Kaszynski said the Stanford Solutions team was discussing a clinical trial in the US and working to form a global alliance in the fight against the pandemic .

White said InfraSalience, which is assisting Avigan manufacturer Fujifilm Toyoma Chemical with the adoption of the drug, said the pressure on politicians and health officials was clouding their access to important information.

"It is our responsibility to help present the crucial information they need to make the right decision for the sake of economies, health systems and people.

"All we ask is that ministers pick up the phone and speak to Stanford University. This is an affordable, safe and time-tested effective solution for Covid-19." he said. "If we have ministers that see what Japan and Israel are doing, can't those ministers make their own decisions without waiting for WHO?"

Prof Wolfgang Preiser, an expert in virology at Stellenbosch University, told the Sunday Times: "Many different drugs are being repurposed for Covid-19. So far, studies are small and are mostly not well controlled.

"Yes, it is an emergency, but if we're not sure, one might make things worse. The solution is emergency trials, and these are being set up by many countries.

"So, it is happening, but in an organised way that will lead to a much better understanding as to what may be useful and what not."