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Hydroxychloroquine is being discarded prematurely in COVID-19 prevention

COPCOV COVID-19 MORU Bangkok

Hydroxychloroquine could still prevent COVID-19 and save tens of thousands of lives around the world, say leading scientific researchers. While it doesn’t work in treatment of hospitalised patients, it could still prevent infections. However, fraudulent data, unjustified extrapolation and exaggerated safety concerns together with intense politicisation and negative publicity may stop COPCOV, the only large, global clinical trial testing hydroxychloroquine in COVID-19 prevention, from ever finding out.

Medicine Quality Scientific Literature Surveyor

LOMWRU Research

IDDO and MORU released its Medicine Quality Scientific Literature Surveyor. The surveyor delivers summaries of published scientific reports on the quality of the classes of essential medicines listed below, across regions and over time. We hope it will help medicine regulators, scientists, health professionals, purchasers and officials fill critical information gaps.

New Oxford academic titles for MORU colleagues

Awards & Appointments

The results of the University of Oxford’s Recognition of Distinction exercise for Associate Professor and University Research Lecturer are in, and I am delighted to announce that the University has conferred titles on the following MORU staff:

UK regulator gives green light to clinical trial of hydroxychloroquine to prevent Covid-19 in healthcare workers

COPCOV COVID-19 MORU Bangkok

The UK regulator MHRA announced on 26 June that it would again permit recruitment to the COPCOV COVID-19 prevention clinical trial. The MHRA decision came 5 weeks after it reacted immediately to the now-discredited paper published in The Lancet suggesting harms with hydroxychloroquine, and paused recruitment of UK participants. But The Lancet paper was based on fabricated data and was swiftly retracted. After this interruption, recruitment around the globe to COPCOV can now resume.

COVID-19 prevention and treatment: a critical analysis of chloroquine and hydroxychloroquine clinical pharmacology

COPCOV COVID-19 MORU Bangkok Publication

Paper by NJ White et al, PLoS Medicine, in press. Using available pharmacokinetic information from healthy volunteers, the treatment of malaria, the chronic treatment of rheumatological conditions and the toxicokinetics of chloroquine in self-poisoning, the authors predict exposures and safety margins in the high dose chloroquine and hydroxychloroquine COVID-19 prevention and treatment regimens currently under evaluation. These regimens are predicted to have reasonable safety margins. Large, well conducted randomised clinical trials with appropriate monitoring are required to determine if chloroquine and hydroxychloroquine have preventive or treatment efficacy in COVID-19 and acceptable safety. Current recommendations for their use outside of clinical trials are not justified at this time.

Major medical journals retract Covid-19 studies

COPCOV COVID-19 MORU Bangkok

On 4 June 2020, after a week of increasing scientific concern and scrutiny, first The Lancet, then the New England Journal of Medicine, retracted studies that were based on inaccessible data. The studies have been extremely damaging to chloroquine and hydroxychloroquine COVID-19 clinical trials around the globe. MORU researchers played a key role in bringing this scandal to light, whose consequences continue to play out.

Clinical trials on hydroxychloroquine/ chloroquine in COVID-19. Statement in response to damaging recent events

COPCOV COVID-19 MORU Bangkok

On 4 June 2020, after a week of increasing scientific concern and scrutiny, first The Lancet, then a little over an hour later the New England Journal of Medicine, retracted studies that were based on inaccessible data, provided by the Surgisphere corporation. The studies have been extremely damaging to chloroquine and hydroxychloroquine COVID-19 clinical trials around the globe. Here is MORU’s statement in response to these events.

An open letter to Richard Horton, editor of The Lancet regarding Mehra et al

COPCOV COVID-19 General

The results of Mehra et al in The Lancet have had a considerable impact on public health practice and research, halted trials and caused considerable concern to participants and patients enrolled in randomised controlled trials (RCTs). This has led many researchers around the world to scrutinise in detail the publication and outline their concerns in this letter to Richard Horton, editor of The Lancet.

COPCOV study paused

COPCOV COVID-19

We received notice from the UK's MHRA (Medicines and Healthcare Products Regulatory Agency) to pause for now new enrolment into our COPCOV study. We responded promptly to the MHRA, addressing their concerns in detail and await their decision. For now, COPCOV study enrolment is paused around the globe. The safety of our participants is our first priority, as is preventing illness in front-line healthcare workers.

Global clinical trial of 40,000+ healthcare workers begins to test in UK if chloroquine and hydroxychloroquine can prevent COVID-19

COPCOV COVID-19 MORU Bangkok Research

A global study to test if either chloroquine or hydroxychloroquine can prevent COVID-19 in vital frontline healthcare workers will open to UK participants at hospital sites in Brighton and Oxford today.

SEBCOV study launched today

COVID-19 MORU Bangkok Research

The SEBCOV study aims to produce evidence to inform public health measures such as communications, quarantine, self-isolation, social distancing, and travel restrictions for the COVID-19 pandemic. This study is run in four countries: UK, Thailand, Italy and Malaysia.

PAL forest malaria prophylaxis study begins in Cambodia

MORU Bangkok Research

The Epidemiology Department of MORU and National Malaria Control Programme, Cambodia (CNM) have begun to implement a study to assess the efficacy of prophylaxis with artemether-lumefantrine (PAL) against forest malaria in Siem Pang District, north-eastern Cambodia bordering Laos.

GroupMappers create real-time COVID-19 Bangladesh dashboard

COVID-19 MORU Bangkok

The impact of COVID-19 is quite evident at present – entire countries and cities are under lockdown, offices and industries shut and academia at a standstill. However, many people in Bangladesh remain unaware or indifferent to the warnings and safety protocols that ought to be followed to stop COVID-19’s spread. Since enforcing social distancing in a densely populated country like Bangladesh is very challenging, making people aware and maintenance of hygiene are the main means to stop the spread of COVID-19.

COPCOV Covid-19 study prepares to begin participant enrolment

COPCOV COVID-19 MORU Bangkok Research

Less than a month after it was announced, the MORU-led COPCOV study has made quick progress and expects to begin enrolling participants by the end of April.

Global call for strategic planning for COVID-19 medical products

COVID-19 LOMWRU Publication

Global health experts have united in a call for governments and international organisations around the world to plan strategically for the coordinated production, equitable distribution and surveillance of COVID-19 medical products to ensure access to quality-assured medications for everyone.

BBC World News interviews Nick White on chloroquine and hydroxychloroquine for COVID-19: “These drugs are not harmless, they’re dangerous in over-dose.”

COPCOV COVID-19 MORU Bangkok Public Engagement

There are currently no proven vaccines or drugs to prevent COVID-19. In this BBC World News interview, MORU’s Prof Sir Nick White explains why the only way to find out if chloroquine and hydroxychloriquine work against COVID-19 is via randomised, clinical trials and how the hype over chloroquine negatively affects people with lupus and rheumatoid arthritis.

COVID-19 Therapeutics Accelerator awards $20 million in initial grants to fund clinical trials

COPCOV COVID-19 MORU Bangkok Research

Researchers at MORU and two institutions in the US (University of Washington and La Jolla Institute for Immunology) receive grants from the COVID-19 Therapeutics Accelerator, a large-scale initiative launched by the Bill & Melinda Gates Foundation, Wellcome, and Mastercard to speed the development of and access to therapies for COVID-19.

Triple drug combinations effective against drug-resistant malaria

MORU Bangkok Publication Research

Adding a third anti-malaria drug to current artemisinin-combination therapies (ACTs) provides effective treatment against multidrug-resistant falciparum malaria in Southeast Asia, say Oxford researchers in a study in The Lancet. Using TACTs should extend current malaria drugs so drug-resistant malaria doesn't kill millions more and derail hopes of controlling and eliminating malaria.

Why is WHO failing women with falciparum malaria in the first trimester of pregnancy?

Research SMRU

From The Lancet Correspondence. In the opening to the 2019 World Malaria Report, entitled Leaving no one behind in the march to a malaria free world, the WHO’s Director-General notes that the scourge of malaria continues to strike hardest against pregnant women and children in Africa.

Women and Girls in Science Day 2020

General

The International Day of Women and Girls in Science recognises and celebrates the critical role played by women but also aims to promote their full and equal access to participation in science. However, despite more women than ever working across the sciences, it is still a male-dominated field with only 30% of female researchers, according to UNESCO. IDDO asked colleagues across their networks for their views. How we could encourage more women into science? And what changes are needed in order to keep them in science?

Art exhibition on substandard and falsified medicines comes to Bangkok

MORU Bangkok Public Engagement

When we are ill, we expect our medicines to work as intended. But what if they do not contain the ingredients listed on the packaging? The Pharmacide Arts exhibition “What’s in your medicines?” showcases the original artwork of 11 South East Asian artists. The exhibition is open to the public from 26th-28th January 2020 at the Mandarin Hotel, Bangkok, from 10 am – 5 pm.

Global study highlights the extent and impact of drug-resistant enteric fever and the urgent need for new approaches

MORU Bangkok Publication Research

A new study conducted by Christiane Dolecek and colleagues analysed data on antimicrobial resistance of the bacteria Salmonella Typhi and Salmonella Paratyphi, from around the globe, spanning the time from 1990 to 2018. The study highlights the impact of drug resistance and the urgent need for interventions.

Joel Tarning wins Ashford award at ASTMH 2019

Awards & Appointments MORU Bangkok

Professor Joel Tarning received a Bailey K. Ashford Medal at the ASTMH 2019 Conference. The medal is awarded annually for distinguished work in tropical medicine by an early- to mid-career ASMTH member. Joel is Head of Clinical Pharmacology at MORU and his work focuses on applying pharmacokinetic-phamacodynamic modelling to optimise antimalarial drug therapies, in particular for at-risk groups such as malnourished children and pregnant women.

Oxford named best for medicine for ninth consecutive year

Awards & Appointments General

Oxford University has been ranked as the world's best institution for medical and health teaching and research for the ninth consecutive year in the latest Times Higher Education World University Rankings. The ranking is based on criteria measuring teaching, research, industry income, international outlook and citations, which are combined to provide a comparison of universities worldwide.

Call for global action on medicine quality

LOMWRU Publication

Noting that substandard and falsified medical products (including medicines, vaccines, biologics, and diagnostics) represent a significant and growing threat to human health, The Lancet Global Health published 'The Global access to quality-assured medical products: the Oxford Statement and call to action'.

Artists explore the problems of poor quality and fake medicines

LOMWRU Public Engagement

When we are ill, we trust that the medicines that we take will make us feel and be better. But what if our pills do not contain the ingredients listed on the packaging? The art exhibition ‘What’s in your medicines?’ explores how substandard and falsified (‘fake’) medicines can affect our health, by showcasing the striking and original artwork of 12 South East Asian artists.

Congratulations new TropMed professors

Awards & Appointments MORU Bangkok

Oxford Medical Sciences Divisional Panel has conferred the title of Professor on three members of our Centre. Ben Cooper - Professor of Epidemiology, Sassy Molyneux - Professor of Global Health and Piero Olliaro - Professor of Poverty Related Infectious Diseases were awarded these titles in recognition of their distinction in their respective fields and contributions to the research, teaching and administration of the Department and we congratulate them on their success!

New research supports co-administration of primaquine with artemisinin-based combination therapies for P. vivax malaria

MORU Bangkok Publication Research

An individual patient data meta-analysis of 2,017 patients from 19 studies has found a high risk of recurrence following treatment of P. vivax malaria with artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP) unless they are co-administered with primaquine. The research supports recommendations that these artemisinin-based combination therapies (ACT) should be combined with primaquine.

Nobel Prize for Medicine awarded to NDM Professor Sir Peter Ratcliffe

Awards & Appointments General

Professor Sir Peter J Ratcliffe, Director for the Target Discovery Institute within the Nuffield Department of Medicine at Oxford University and Director of Clinical Research at Francis Crick Institute, London, has today been announced as a winner of the Nobel Prize in Physiology or Medicine.

Oxford Vice-Chancellor Louise Richardson visits MORU and SMRU

General MORU Bangkok SMRU

MORU and SMRU were delighted and honoured to host the University of Oxford Vice-Chancellor Prof Louise Richardson and her party during her visit to Thailand on 1-4 September. Accompanying the Vice-Chancellor were Jeremy Woodall (Director of Development (Asia)), Frewyeni Kidane (Fundraiser for Southeast Asia), Cher Wu (Asia Development office) and Ed Gibbs (NDM Director of Finance and Operations).

Oxford Tropical Medicine awarded two RSTMH medals

Awards & Appointments General

Two researchers from the Centre for Tropical Medicine and Global Health were awarded medals by the Royal Society of Tropical Medicine and Hygiene at the 2019 European Congress on Tropical Medicine and International Health. Professor David Warrell was awarded the Sir Patrick Manson Medal, and Dr Samson Kinyanjui the Chalmers Medal.

MORU's new Critical Care Asia Network: 42 ICUs in 9 countries

MORU Bangkok Research

In partnership with the Wellcome Innovations Flagship Programme, MORU launched its Critical Care Asia Network project with its first investigators’ meeting on 19-20 Aug in Bangkok. The project will establish an Asian ICU network across 42 ICUs in nine countries and implement a setting-adapted electronic registry.

Oxford ranked world’s best university for fourth year running

Awards & Appointments General

Oxford has been named the world’s number one university for the fourth successive year in the Times Higher Education World University Rankings.

Antimalarial treatments less effective in severely malnourished children

MORU Bangkok Publication Research

MORU researchers have found that severe malnutrition is associated with lower exposure to the antimalarial drug lumefantrine in children treated with artemether-lumefantrine, the most common treatment for uncomplicated falciparum malaria. The study, which is the first to specifically address this, calls urgently for further research into optimised dosing regimens for undernourished children.

Rapidly spreading multidrug-resistant parasites render frontline malaria drug ineffective in southeast Asia

MORU Bangkok Publication Research

A rapidly evolving multi-drug resistant lineage of P. falciparum malaria parasites continues to spread in South East Asia, leading to alarmingly high treatment failure rates in Cambodia, Thailand and Vietnam for DHA-piperaquine, one of the world’s most important anti-malaria drugs.

New study shows faster way to cure vivax malaria

MORU Bangkok Publication Research

A large clinical trial in Africa and Asia has shown that a 7 day course of high dose primaquine, a drug used to treat P. vivax malaria, is well tolerated and just as effective as the current standard 14 day regimen, according to a study published this week in The Lancet. These findings have important implications for the treatment and elimination of vivax malaria in the Asia Pacific.

Research to investigate the prevalence and causes of rickets in remote NW Myanmar

MOCRU Research

Medical Action Myanmar and MOCRU health teams identified a number of children with rickets in remote areas of Myanmar. MOCRU director Frank Smithuis presented the findings of clinical screening to the Minister of Health, alongside treatment results and a plan for a large survey to investigate the prevalence of vitamin D deficiency and its underlying causes.

Village drama against malaria project wins University Public Engagement with Research Award

Awards & Appointments Conferences & meetings MORU Bangkok

A project using drama that engages with village communities in Cambodia, led by Professor Phaik Yeong Cheah of the Mahidol Oxford Tropical Medicine Research Unit and Nuffield Department of Medicine, has won a Project award in this year’s Vice-Chancellor’s Public Engagement with Research Awards. The project also won the Vice-Chancellor’s Choice Award for Public Engagement with Research.

Longer follow-up needed for malaria treatment in pregnant women

Publication Research SMRU

New research by Makoto Saito and colleagues at SMRU found that a longer follow-up is required to assess antimalarial drug efficacy in pregnant women. This was found across all drugs assessed in low malaria transmission settings. The report’s authors have called for guidelines specifically for pregnant women and further investigation of optimal follow-up periods in high malaria transmission settings.

BBC News: Big data 'can stop malaria outbreaks before they start'

MOCRU

A ground-breaking study in Bangladesh co-lead by Mahidol Oxford Tropical Medicine Research Unit (MORU) has found that using data from mobile phone networks to track the movement of people across the country can help predict where outbreaks of diseases such as malaria are likely to occur, enabling health authorities to take preventative measures.

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