The claim that anti-malaria drugs, chloroquine and hydroxychloroquine, can cure COVID-19 became a focus of fierce political battles that pitted promoters of these pharmaceuticals, Presidents Bolsonaro and Trump among them, against "medical elites." At the center of these battles are different meanings of effectiveness in medicine, the complex role of randomized clinical trials (RCTs) in proving such effectiveness, the task of medical experts and the state in regulating pharmaceuticals, patients' activism, and the collective production of medical knowledge. This article follows the trajectory of chloroquine and hydroxychloroquine as anti-COVID-19 drugs, focusing on the reception of views of their main scientific promoter, the French infectious disease specialist, Didier Raoult. The surprising career of these drugs, our text proposes, is fundamentally a political event, not in the narrow sense of engaging specific political fractions, but in the much broader sense of the politics of public participation in science. [COVID-19, chloroquine, hydroxychloroquine, randomized clinical trials, AIDS activism]
This article follows the introduction of COVID-19 polymerase chain reaction (PCR) diagnostic tests in France. It shows how, at the intersection of science, medicine, politics, and policy-making, the test, trace, and isolate (TTI) strategy played out during the first months of the pandemic against a backcloth of multiple shortages. In so doing, the authors move beyond trite explanations (such as ‘French public health’s backwardness’) to highlight how successive policy inflections affected the national response to the pandemic. The piece analyses the shifting French political discourse surrounding (scarce) COVID-19 tests while exploring ad-hoc regulations and guidelines as well as the intense ‘bricolage’ that they triggered in the field of clinical medicine. The authors contend that the limitations of the testing infrastructure in France during the first half of 2020 shaped the decision to resort to lockdown. The research article sheds light on two coexisting registers of professional uses of reverse transcription-polymerase chain reaction (RT-PCR) assays—a ‘public health use’ and a ‘clinical use’—and highlights the changing political and social relevance of these two registers, with scarcity as a major determinant of these changes. One of the striking aspects of the introduction of COVID-19 tests in France therefore lies in the enduring gap between the dynamics of the epidemic and the dynamics of testing. In this respect, the French situation is neither extreme nor unique, which makes this case study a relevant basis for the international comparison of testing practices in different phases of the COVID-19 pandemic.
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