Does Remdesivir Deserve The Hype?

Here is today’s Foreign Policy brief: U.S. to fast track coronavirus treatment, U.S. Secretary of State Mike Pompeo urges U.N. to continue Iran arms embargo, and South Korea reports zero new coronavirus cases in 24-hour period.

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The U.S. Food and Drug Administration is set to announce an emergency-use authorization for a drug to treat COVID-19 after it showed promising results in an international trial. The drug, remdesivir, was originally developed by Gilead Sciences to treat the Ebola virus.

The trial, sponsored by the National Institutes of Health (NIH), was conducted on over 1,000 people and showed that patients receiving the drug recovered up to four days faster than patients taking a placebo.

Anthony Fauci, the head of the U.S. National Institute of Allergy and Infectious Diseases, described the trial’s results as “very optimistic.”

“The data shows that remdesivir has a clear-cut, significant, positive effect in diminishing the time to recovery,” he said during a meeting with U.S. President Donald Trump.

Japanese Prime Minister Shinzo Abe announced that Japan’s health ministry would also fast track approval for the drug.

But it’s not that simple. On Wednesday, the British medical journal The Lancet published the results of a separate remdesivir study conducted on 237 patients across 10 hospitals in China’s Hubei province. The authors of that study found remdesivir “was not associated with statistically significant clinical benefits.” However, the Chinese trial did find that the drug reduced the time required for a patient’s condition to improve among those showing symptoms for 10 days or less, prompting the authors to recommend further study.

The WHO is being cautious. The World Health Organization cautioned that relying on any single study is unlikely to be the solution in finding an effective treatment for the coronavirus. “Typically, you don’t have one study that will come out that will be a game changer,” said Maria Van Kerkhove, who is leading the WHO’s technical response to the coronavirus pandemic. “Once we look at all of the studies, and we judge them collectively, we can come away with some kind of a conclusion of ‘yes we see an effect’ or ‘no we don’t,’” she said.

How much remdesivir is available now? In an interview with STAT on Wednesday, Gilead CEO Daniel O’Day said the company began ramping up production of the drug in January in the hope that it would be effective. He said the company had produced 50,000 treatment courses to date, and expected that number to increase to 140,000 treatment courses between now and July.

What about the cost? Gilead’s stock price rose 5.68 percent after news of the NIH study broke, and as with any private company faced with a desperate public, there is a worry that Gilead could seek to profiteer. O’Day said there would be “no obstacles” to accessing the drug if it’s proven effective. “Gilead will continue to take its responsibility very seriously here and make sure that whatever model we come up with will ensure access around the globe, and that patients are put first,” he said.

Is the United States still a party to the Iran nuclear deal? When Washington wants to sanction Iran, it seems to think it is. The Trump administration is looking to its fellow members of the United Nations security council to support the United States in extending an arms embargo against Iran, due to be lifted on October 23. Under the terms of U.N. Security Council resolution 2231, the resolution that endorsed the Iran deal, any country can reimpose sanctions if parties are believed to be in breach of the deal.

U.S. Secretary of State Mike Pompeo has pushed back against the idea that just because the United States withdrew from the agreement it is excluded from enforcing parts of it. “Someone suggested this is fancy lawyering. It’s just reading,” he told a State Department press briefing.

Pompeo also called on the European nations who were parties to the Iran deal to join the United States in extending the arms embargo. “Does anybody think that the nation that today is conducting terror campaigns by Lebanese Hezbollah or Iraqi Shia movements or firing military missiles into the air ought to be permitted to purchase conventional weapons systems in just a few months? I think the world realizes that’s a mistake,” he added.

Bolsonaro appointee blocked. Brazil’s Supreme Court has blocked the appointment of Alexandre Ramagem as Brazil’s new chief of federal police, saying that Ramagem’s close relationship with the Bolsonaro family put him in a compromising position. Bolsonaro had already been criticized for the appointment by Sergio Moro, who recently resigned as justice minister. Moro alleged that Bolsonaro had interfered with federal police investigations prior to stepping down.

The high-profile departures of Brazil’s health and justice ministers from Bolsonaro’s cabinet have increased pressure on the president, whose handling of the country’s coronavirus crisis has been deemed ineffective by a majority of Brazilians. On Tuesday, Brazilian reporters asked Bolsonaro for his opinion on the record number of deaths recorded that day. “So what?” Bolsonaro replied. “I’m sorry. What do you want me to do?”

Yemen records five more coronavirus cases. The Southern Transitional Council (STC), a separatist group that declared self-rule over southern Yemen reported five more cases of coronavirus yesterday, adding to the single case that had been reported previously. The authorities announced a three-day, 24-hour curfew in response to the news.

On Tuesday, the United Nations warned of “a very real probability” that the coronavirus was spreading unchecked in the country due to its already war-ravaged health infrastructure.

War crimes in Myanmar. The outgoing U.N. special rapporteur on Myanmar, Yanghee Lee, called for an investigation into allegations of war crimes in the states of Rakhine and Chin, highlighting offenses by both government and nonstate actors. “While the world is occupied with the COVID-19 pandemic, the Myanmar military continues to escalate its assault in Rakhine State, targeting the civilian population,” she said. “Its conduct against the civilian population of Rakhine and Chin States may amount to war crimes and crimes against humanity.”

She called on the U.N. to step in to avoid “another systemic failure,” a reference to the Myanmar military’s deadly crackdown on the Rohingya community. Civilian deaths have increased in Rakhine state over the past year as government forces clashed with the Arakan Army, an ethnic Rakhine rebel group seeking greater autonomy from the central government.

South Korea reports no new domestic coronavirus cases. South Korea reached a key milestone in its much-lauded battle with the coronavirus as it recorded no new domestic cases over a 24-hour period for the first time since February. The Korea Centers for Disease Control and Prevention (KCDC) did report four new cases, although all of them involved people entering the country from abroad.

Authorities in the Swedish city of Lund have devised a novel way to ward off crowds for an upcoming day of national celebration: chicken manure. The Walpurgis festival is usually an all-day, alcohol-fueled party to celebrate the coming of spring, with mass gatherings and bonfires part of the fun. With no formal lockdowns in place across Sweden, Lund’s municipal workers will spread a ton of chicken manure in its central park to deter such revelry.

“We get the opportunity to fertilize the lawns, and at the same time it will stink and so it may not be so nice to sit and drink beer.” Gustav Lundblad, chairman of the local council’s environment committee, told the Sydsvenskan newspaper.

That’s it for today.

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