<p>Off-Label Use of Chloroquine and Hydroxychloroquine for COVID-19 Treatment in Africa Against WHO Recommendation</p>

Abstract

COVID-19 is continuing as a big challenge for the globe and several types of research are continued to find safe and effective treatment and preventive options. Although there is a lack of conclusive evidence of their benefit, there is worldwide controversy to use anti-malarial drugs, hydroxychloroquine and chloroquine, for the treatment of COVID-19. FDA issued an emergency use authorization to the use of these drugs for the treatment of COVID-19. On the contrary to the FDA, the European Medicines Agency has warned against the widespread use of these drugs to treat COVID-19. Finally, the WHO declared that clinical trials on these drugs are halted after the devastating findings of the study published in the medical journal called The Lancet. Against this fact, there are several rumors about the irresponsible use of these drugs in Africa for the treatment of COVID-19. This work aimed to review the off-label use of these drugs for the treatment of COVID-19 in African countries against WHO recommendation. Data on the use of these drugs for the treatment of COVID-19 in African countries were searched from credible sources including Scopus, PubMed, Hindawi, Google Scholar, and from local and international media. The study showed that many African countries have already approved at the national level to use these drugs to treat COVID-19 by opposing WHO warnings. In addition to this, falsified and substandard chloroquine products started to emerge in some African countries. The health sectors of the African government should critically compare the risks and benefits before using these drugs. The WHO and African drug regulatory organizations should intervene to stop the off-label use practice of these drugs against the licensed purpose and distribution of falsified and substandard products in the continent.

Evaluation of the Current Therapeutic Approaches for COVID-19: A Systematic Review and a Meta-analysis

“…The results revealed that there is no significant improvement in these patients within 15 days ( Cavalcanti et al, 2020 ). Although the World Health Organization (WHO) recommends against using these drugs due to the limited evidence, most African countries are still utilizing them as the routine COVID-19 treatment ( Belayneh, 2020 ).…”

Antimicrobial resistance and COVID-19: Intersections and implications

“…However, misinformation ( Arshad et al, 2020 ), the lack of other treatment, combined with the severity of the illness, and a desire to try all avenues have led to several settings continuing to use these drugs. For example, in many African countries, despite WHO recommendations, hydroxychloroquine, chloroquine, and azithromycin were still being advised for use in the summer of 2020 and may be still being used off-label ( Abena et al, 2020 ; Belayneh, 2020 ). In India, it appears to still be guidance to use hydroxychloroquine as a prophylactic for ‘healthcare workers’ ( National Taskforce for COVID-19, India, 2020 ).…”

Metabolic N-Dealkylation and N-Oxidation as Elucidators of the Role of Alkylamino Moieties in Drugs Acting at Various Receptors

“…Even though there is a clear lack of adequate evidence of benefit of the drugs, many African and other countries have endorsed hydroxychloroquine repurposed (off-label) use for the treatment of COVID-19 contrary to the WHO recommendations [ 179 ]. On the other hand, the US Food and Drug Administration have also issued an Emergency Use Authorization for the use of chloroquine and hydroxychloroquine for the treatment of Covid-19 in adult populations [ 180 ].…”