TEMPO.CO, Jakarta - PANDU Riono found himself a target of a cyber-attack following his criticism towards the government for the latter's handling of the Covid-19 pandemic. The Twitter account belonging to the epidemiologist with the faculty of public health, University of Indonesia, was hacked last Wednesday, August 19. Pandu views the attack as an attempt to divert attention away from the real issue at hand -- the unsuccessful management of the pandemic -- to him who is seen as 'lecturing'. "We should always remember that our enemy is Covid-19, not the government or others," Pandu, 64, said during a video interview with Tempo on Wednesday, August 19.
Pandu is one of a few scientists who are critical of the government's Covid-19 response policies. Most recently, he criticized the joint venture between a research team of Airlangga University (Unair), Surabaya, East Java, and the State Intelligence Agency (BIN) and the Army in search of the Covid-19 cure. Unair claimed that a cocktail of drugs had the potential to become the first Covid-19 cure. Meanwhile, Pandu said the process and the clinical trial of the combined drugs lacked transparency and, reportedly, did not meet the international standards.
This is not the first time Pandu calling out the government for various irregularities in the Covid-19 policies. He, for instance, vigorously called for the discontinuation of rapid tests, urging the government to enhance testing and contact-tracing. He also pointed out that the Covid-19 taskforce's performance had not been optimal. "Actually, the task force was unnecessary because we already have the health ministry," he said. From the outset, Pandu felt that the Covid-19 management command should be under the direct control of the President.
The former member of the National Bird Flu Control Commission who calls himself a pandemic expert talked about the importance of procedures in clinical trials of drugs, effective measures to combat the pandemic, and his critical stance towards the government. The interview was supplemented with WhatsApp chats on August 20.
You've said that you would challenge Unair's Covid-19 drug if it passes the clinical trial and later gets registered at the Drug and Food Monitoring Agency (BPOM). What are your considerations?
A reporter asked me about it and I just heard that time that the Unair research team reported to the Army chief of staff. I questioned why they should report to the Indonesian Military (TNI), even more so when I learned that it was the Army chief of staff himself who took it to the BPOM for expedited distribution permit. I found it odd. It's pity for the BPOM if they went there for the permit straight away. It's as if the whole thing is fait accompli.
Which part of the Unair's research do you disagree with?
I disagree with the process although I don't know yet the result. From what I understand from the PowerPoint presentation submitted to the TNI which can be downloaded at the TNI's website, the clinical trial rules do not meet the standards. Perhaps there are procedures that were not followed. That casts doubt on the process. Moreover, I didn't find the protocol (in the presentation).
What should the protocol look like?
Usually, there is a protocol to follow in the international drug registration process, how the clinical trial process is done. Both the WHO (World Health Organization) and the United States have clinical trial registries to document clinical research and trials. Many researchers in Indonesia who are doing vaccine or convalescent plasma research, for example, register their trials there so everything is transparent. I looked for Unair's research there but it wasn't there. There must be unusual procedures involved. I raised questions about the procedures from the start when they discovered that drug cocktail. After all, it was cellular level research but it had been used directly for humans. The drugs used for the combination are already in use. The trial is for drug repurposing.
So, it's not something new?
Several global clinical trials, including one in which Indonesia is involved called Solidarity Clinical Trial, are testing the use of existing drugs including hydroxychloroquine, remdesivir, and some HIV (human immunodeficiency virus) drugs for Covid-19 treatments on humans.
Can the Unair's drug be called a preparation?
No, it's a combination. Our Unair colleagues used the term preparation (racikan) as they mixed several drugs into one. In Indonesia, it's known as 'making powder'. Drug components are crushed and compounded in a capsule. That seems to be the method. So, they called it a preparation.
What procedures are involved in a clinical trial according to international standards?
If I say ginger can cure Covid-19, I have to prove it in a scientific procedure. I have to do a proper clinical trial. Otherwise, my claim is not credible. Every claim must be based on a research method. The best method to study cause-and-effect relationships is the randomized double-blinded controlled trial method. It compares (the efficacy of) drugs in randomly selected groups of people. Like other vaccine trials, some get the drug, some placebo. As it is a double-blinded trial, no one -- be it the researcher or volunteers -- know who gets what.
Whatever discrepancies did you find in the Unair-BIN-Army research?
What made me doubtful is the use of 1,000 Covid-19 cluster in Secapa (the Army's military cadet school) in Bandung in the trial. Initially, they were conducting the research in hospitals. But as soon as they saw this opportunity, they changed the protocol. They should have consulted with the university's research ethics committee or the health research and development agency for such a protocol change. National research usually needs review from that agency.
To protect the researchers as well as to ensure that they have done the research in line with the standard and that the drug does not cause adverse effects on humans. So, there will be no allegations of human rights violations later on as the treatment can harm or even cause death. This is very important.
Is the recruitment of Secapa students as research subjects wrong?
The fact that some of the students are people without symptoms raises the question. They don't need medication actually. A lot of them recovered, of course.
Read the Full Interview in Tempo English Magazine