Professor Babatunde Lawal Salako is the Director-General of the Nigerian Institute of Medical Research (NIMR). A clinician of high repute, Salako has been involved in a number of clinical trials on drug development. He worked with Neimeth Pharmaceuticals International to formulate the drug Miniplus in 2003 following the disappearance of Minizide in the Nigerian market. Apart from Neimeth, he also did clinical trials on drugs marketed by GlaxoSmithKline, Olpharm Pharmaceuticals, May & Baker and Sanofil Synthelabo Nig, Ltd. Salako said in this telephone interview that the Nigerian government has given NIMR the go ahead to investigate the veracity of Professor Maduike Ezeibe’s claims on HIV cure. He also talked about what the research institute is doing with regards to the rampaging Coronavirus (COVID-19) pandemic and other sundry issues. Excerpts:

How is NIMR reacting to the rampaging COVID-19 pandemic?

We have been doing a lot. We have been involved in screening of patients. We are part of the network of laboratory diagnosis in Lagos State, and as I speak with you, we have tested close to 1,500 samples. We also organised the first ever drive through in Nigeria and in West Africa where people drive in after an appointment and get tested and then drive out without having to get down from their vehicles, and that is free. This has assisted in increasing the number of people who get tested in Lagos State.

What other things is the institute doing with regards to COVID-19?

Beyond that, on research issues, we are the first to also sequence the virus in an index state. What that means is that we are able to do the viral architecture (the make-up of the virus) to confirm that it’s actually the virus that is ravaging the country. We do that immediately a patient is admitted. The other reason for doing that is to monitor the ability of the virus to change from the original copy, which is called mutation. The virus can change for the better or for worse. So, we need to continue monitoring that as the virus rages on within the country and we will still continue to do that as part of our research work.

Is there any other advantage for such sequencing?

Another advantage of doing that is for us to look at the architecture and how it’s becoming a spike that can be targeted for diagnostic development and also how that can be targeted for blood development. These are very advanced research medicines, but with the knowledge of the architecture of the virus, these are the things that can be known. As I speak, we have researched into development of homegrown kits based on the sequences that we have done and we are looking at three types of kits. We should have come up with one but for the channel in getting some of the reagents as international flights have been banned, and the taxes of those working has been increased beyond what we can pay for. So, it’s like we are waiting for our reagents, some of them are stocked in the UK, but we are praying and hoping. If those things arrive today, we should come up with the item within the next few weeks.

Chloroquine was said to be the magic wand for COVID-19 a few weeks back. Are you looking at that drug too?

We are looking at that; very soon we should start a trial in Lagos, basically with the University of Lagos Teaching Hospital (LUTH) to determine the efficiency of Chloroquine or any other drugs on the virus and the outcome of it on those we are going to test. That should provide good information for Nigerians on whether to use chloroquine or not. We are also looking at people’s behaviour that may have affected the spread of the infection, their knowledge and attitude, what they think about the virus as some people still don’t believe the virus exist. So, we go into the communities to determine their knowledge, practice, how these affect the spread of the infection.

So, that already is ongoing.

Is NIMR doing this alone?

We are working with the consortium of NCDC, NIMR and another university in London to look at the antibody developments against the virus within the community, this can provide information on how far the disease has been in the community or how many people have come in contact with the virus within the community and that will give us a level of how ready the community is in catching the infection and those antibodies can be adopted, produced and they can be a source of immunological part of the treatment.

What categories of people are coming to NIMR for screening and testing?

What we did was to advertise on our website, like if you think you have a risk of developing COVID-19, visit our website and complete a form. We will check to determine if you will come for a test or not because we are not checking everybody. The NCDC has strict regulations and because we do not have enough kits, so if you fall into that category, we will invite you. So, one can only come on invitation and not just walk into the centre.

Some people have argued, like you just mentioned, that the antibodies of those who have been found to be COVID-19 free should be used as a basis for a possible development of vaccines for the virus. Is that what you are trying to explain?

Well, we are not saying that yet, but I am aware that at the isolation centres, people who have recovered from the disease have their plasma harvested because that’s where you find their antibodies and kept for possible use for patients who needs it or who might develop sever illnesses in the future so they can then transmit it since they have their antibodies developed against the virus to help curb the virus. That is currently ongoing.

There are fears in some quarters also, especially for those who are living with the human immunodeficiency virus (HIV) as per the sustainability of the anti-retroviral drugs since flights are not allowed all over the world for now. Are there enough stock to sustain them and for how long?

What we have done was to give them three months’ supply and I think there is enough supply for most patients within the country now, and hopefully the COVID- 19 pandemic might seize before the end of the three months, so they can always get another round of the drugs. Of course, international flights have been banned, but there are cargo flights that are still working, like essential flights to countries where they are needed. I believe that all over the world, the HIV drugs will continue to be manufactured and distributed to countries where they are needed.

We understand that most of the HIV drugs are coming from India. Are you reassuring that India will be willing to continue to supply that in spite of what’s happening now?

I imagine so, even though I’m not the one in charge and I can’t speak for them. But I imagined that that should happen because they belong to a special group of people that must necessarily continue to take their drugs because that condition may make infection by COVID-19 worse, especially if they are not taking their drugs. So, I think the government and development partners will ensure that those drugs flow and supply continues.

There have also been reports about the need for people to take vitamin C, 1000, to help boost their immunity. Will this not interfere with the anti-retroviral drugs taking by HIV patients?

Well, I think vitamin C is such a common drug that will be useful if taking appropriately as prescribed to boost immunity. But, the problem is that HIV is attacking immunity. So, it may not be as effective for those living with the virus as against those without the virus. This is because the virus is still in the system. What the HIV drugs do is to help reduce the viral load and bring up the CD4 count or simply put, boost the immunity so that the patient can function maximally. So, for such people, vitamin C will take a slow pace. However, that does not mean that it can’t work on those with the virus only that it will take a longer time unlike those without it.

What about garlic and ginger that have become hot cakes now?

Those are all food additives and people have been taking them for ages. So, I don’t think there is anything wrong with people living with HIV or any person for that matter taking them.

Madagascar is reported to have developed a homegrown cure for COVID-19 from local herbs. Is NIMR looking at collaborating with trado-medics in Nigeria in that direction?

There have been so many Nigerians claiming to have developed a cure for COVID-19 using herbal medicine but this has to be tested. Again, government has to have a platform to pronounce that herbal medicine could be tested for COVID-19. So, there has to be such clearance. Without that, we can’t on our own try such because we are government institution, which is regulated by government. We cannot take any herbal medicine and start giving to individuals without official approval. However, if we are talking about using herbal drugs to treat ailments like diabetes and hypertension, for instance, that’s a different thing. If we talk to patients and they are willing to take that, fine. But, an outbreak like this novel COVID-19, everyone is trying to extra-careful so as not to aggravate the situation. But, if we have government backing to try that, and we have people who can volunteer to try it, why not. That is my view about that. That is not to say that herbal medicine cannot work, just that there are processes for testing these drugs. I don’t know what processes Madagascar took for them to be able to give it a national support for people to be taking it.

But, as a research institute, is there no way it can collaborate with the traditional medicine practitioners to find a possible solution to this menace?

We are already doing that. We are using many of their drugs but not in this novel situation, that’s what I’m saying. We have been discussing with government and will continue to discuss with them to come up with a policy that we can try herbal medicine. The problem is, most of the herbal drugs, we don’t know what they are, what they contain. That is part of what we need to find out or research on before we can start talking about can it cure it. We need to find out first if it’s safe for people to take them.

A Professor of Veterinary medicine at the Michael Okpara University, Umudike, Abia State, Maduike Ezeibe, has been saying that he had developed a drug that could cure HIV. Has he ever made a presentation to your institute for evaluation in recent past?

Government has directed us to look at it, and we are doing that. We have been doing that now for the past three months, and very soon, we will be able to come out with our conclusions.

Ezeibe also said recently that the drug could effectively tackle COVID-19. Did he mention that to your institute?

Well, I’m not aware of that but I think we should certify the drug for HIV cure first before we can start talking of COVID-19. Our mandate from government is to investigate his claims of cure for HIV, and we are doing just that as we speak.

What’s your advice for those living with HIV against this pandemic?

I believe that such people are more at higher risk and so, I would sincerely advice those in that group bracket to observe strictly the stipulated guidelines from the Nigerian Centre for Disease Control (NCDC) and the world health bodies. It pays them more to do that; to be preventive rather than allow COVID-19 infection. So, things like face mask, social distancing, and avoiding crowd are compulsory for them. If possible, they should stay at home for this period to avoid mixing up with all manners of people at this point in time. This is because they have the tendency to succumb easily to the infection because of their compromised immunity. Aside that, hand washing for now should also be a routine for them and of course the use of hand sanitizer. More importantly, they should try to avoid public transport as much as they can. If they do that, they will be fine. However, if they notice any little changes in their health system, like sneezing often, coughing and fever, they should quickly get in touch with their doctors because that is very important. If they neglect that, it could be catastrophic for them and of course, they should continue to take their anti-retroviral drugs and stay safe.

How effective is the home-made face masks that have become fashionable in the country now?

Well, it supposed to be effective in a way, maybe not as effective as the other medical masks, particularly the N95 respirator. But at least, using it in public prevents droplets from reaching your mouth and it prevents droplets from you getting to others. If that’s the only thing it can do, that’s a lot. However, even when you wear a mask, keeping social distancing remains a must. The mask must never replace social distancing, rather it should complement it. All you need to do is to ensure that the masks (home-made) are washed with hot water, detergent and iron it because the temperature of the hot iron will take care of any stocked particles that you may not notice. (New Telegraph)

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