by Ayele Addis Ambelu

Today, DNDand its partners will be launching a 13 country clinical trial in Africa (including Uganda) for mild cases of COVID-19 – this will be the largest effort of its kind in Africa, and dovetails with a marked increase in cases in plenty of countries on the continent.

Treating mild cases is key in Africa because ICU capacity is not as strong as may be in other developed nations. All eyes are now turned to vaccines, but vaccines alone won’t be enough to stop the pandemic and save lives. Treatments are just as important.

The goal of this trial, which is named ANTICOV is to identify treatments that prevent mild cases from progressing to severe forms of the disease – and thus prevent local health systems from being overwhelmed. ANTICOV could be compared to SOLIDARITY, but while the SOLIDARITY trial deals focusses severe cases), ANTICOV focusses on mild cases.  It is an adaptive platform trial so researchers can add new treatments as the trial moves on or remove treatments deemed not to be effective as it moves forward.

Hydroxychloroquine will be one of the drugs to be studied initially, because there are no large multi-country studies yet about efficacy of the drug for mild cases. HCQ remains the standard of care for COVID in 16 African countries, so this trial will provide key evidence to inform health policies and national guidelines.

Let me know if you find this news of interest and if you want to clarify anything.

New treatments will be added to the trial as evidence of their potential for mild-to-moderate cases
emerges. ANTICOV researchers are actively looking to select the most promising treatments from
ongoing global scientific efforts with proof of efficacy, in collaboration with the Access to COVID-19
Tools Accelerator (ACT-A) Therapeutics Partnership, co-convened by Unitaid and Wellcome on
behalf of the COVID-19 Therapeutics Accelerator. Among the potential therapeutic options being
explored by ANTICOV are medicines currently used to treat malaria, HIV, hepatitis C, parasitic
infections, and certain cancers. The goal is to include additional treatment arms in the ANTICOV
trial within weeks.
Initially, ANTICOV will focus on drugs where large-scale randomized clinical trials could provide
missing efficacy data in mild-to-moderate patients. The trial will begin testing, against a control arm,
the HIV antiretroviral combination lopinavir/ritonavir and the malaria drug hydroxychloroquine,
which remains the standard of care for COVID-19 today in numerous African countries.
“The ANTICOV consortium is a broad partnership bringing African scientific leaders and global R&D
organizations together to respond to an urgent unmet medical need. Collaboration is the only way to
provide robust scientific responses to these research questions,” said Dr Nathalie Strub-Wourgaft,
Director of COVID-19 Response for DNDi. “The trial was designed in a way that enables rapid and
flexible decisions as we gather knowledge.”
All clinical trial data generated by ANTICOV will be integrated and shared openly and transparently
to inform public health policy. Every effort will be made to work with all relevant partners to ensure
that treatments that prove safe and effective will be affordable, available, and accessible for all.
The trial was reviewed with support from the African Vaccine Regulatory Forum (AVAREF), a
platform established by the World Health Organization (WHO) in 2006, which was recently mandated
to expedite clinical trial reviews for COVID-19. Made up of representatives from countries’ ethical
and regulatory review bodies, AVAREF simplifies and helps accelerate country-level approvals.
ANTICOV is aligned with the WHO R&D Blueprint, which aims to improve coordination between
scientists and global health professionals, accelerate the research and development process, and
develop new norms and standards to learn from and improve upon the global COVID-19 response.
Major funding for the ANTICOV consortium is provided by the German Federal Ministry of Education
and Research (BMBF) through KfW and by the global health agency Unitaid as part of ACT-A. Early
support to launch the initiative was provided by the European & Developing Countries Clinical Trials
Partnership (EDCTP), under its second programme supported by the European Union with additional
funding from the Swedish government, and the Starr International Foundation, Switzerland.
The ANTICOV consortium is mobilizing a wide network of diverse partners with recognised
experience in clinical research. The 26 members of the ANTICOV consortium are:
• Alliance for International Medical Action (ALIMA), France / Senegal
• Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS), France
• Bahir Dar University, Ethiopia
• Barcelona Institute for Global Health (ISGlobal), Spain
• Bernhard-Nocht-Institut für Tropenmedizin (BNITM), Germany
• Centre Muraz, Institut National de Santé Publique, Burkina Faso
• Centre for Research in Therapeutic Sciences, Kenya
• Centro de Investigação em Saúde de Manhiça, Mozambique
• Centro de Investigação e Treino em Saúde da Polana Caniço (CISPOC), Instituto Nacional de
Saúde, Mozambique

Centre Pasteur du Cameroun (CPC), Cameroon
• Centre Pour Le Développement Des Vaccins, Ministry of Health, Mali
• Centre Suisse de Recherches Scientifiques (CSRS), Côte d’Ivoire
• Drugs for Neglected Diseases initiative (DNDi), Switzerland – (coordinating partner)
• Epicentre, France
• Foundation for Innovative New Diagnostics (FIND), Switzerland
• Ifakara Health Institute, Tanzania
• Infectious Diseases Data Observatory (IDDO), United Kingdom
• Institute of Endemic Diseases, University of Khartoum, Sudan
• Institute of Tropical Medicine, Antwerp (ITM), Belgium
• Institut National de Recherche Biomédicale (INRB), Democratic Republic of Congo
• The Kenya Medical Research Institute (KEMRI), Kenya
• Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Ghana
• Medicines for Malaria Venture (MMV), Switzerland
• Swiss Tropical and Public Health Institute (Swiss TPH), Switzerland
• Université de Bordeaux – Institut National de la Santé et de la Recherche Médicale
(INSERM), France
• University of Gondar, Ethiopia