Editorial of the “World”. Didier Raoult appeared in the media arena in February 2020, thanks to a video that cannot be described as premonitory: “Coronavirus: end of the game! The microbiologist, director of the University Hospital Institute (IHU) Méditerranée Infection in Marseille, believed that an antimalarial would quickly put an end to the nascent pandemic. Since then, he has not ceased to defend a protocol of his own, of which no serious study has been able to demonstrate the interest.
Didier Raoult has publicly professed his detestation of the accepted “method” to prove the efficacy and harmlessness of new treatments, based on rigorous clinical trials. It appears, in light of recent revelations of Mediapart and of L’Express, but also reviews of his publications by the specialist in scientific integrity Elisabeth Bik and by anonymous contributors on the PubPeer site, that the researcher did not only theorize his rejection of the common rule: his institute is apparently freed several times, overriding the reserves of the National Agency for the Safety of Medicines.
Justice is seized, and one can hope that all the light will be shed on these practices which, if they were proven, would be contrary to the most elementary ethics and deontology. To free oneself from it is to fall back into the medicine of the XIXe century, when the intuition of a doctor from observations on a handful of patients could lead to the use of inoperative molecules, even deleterious for patients.
The clinical trial system is certainly not perfect. However, and the placing on the market of safe and effective vaccines against Covid, which Didier Raoult considered impossible, amply demonstrates this, these well-conducted procedures are an essential guarantee for reliable and trustworthy medicine.
Figure of scientific populism
The updating of the “Raoult system” should also lead to an examination of what made him king on the Canebière. If he was able to impose the creation of his institute, it is in part because he contributed millions of euros to the Assistance publique-Hôpitaux de Marseille (AP-HM), through a mechanism that monetary rewards hospitals for the number of their publications. Partly thanks to scientific journals where he had contacts, Didier Raoult was able to become a champion of the number of articles whose quantity was not equal to quality.
If we must salute his responsiveness to Covid tests, which he was the first to set up on a large scale, we must also look at the conditions under which the IHU was able to invoice the examinations accompanying the prescription of its protocol, again applied industrially. It will also be necessary to question the governance of an institute from which both Inserm and the CNRS had withdrawn their label in 2018 without it being seriously called into question. We are cruelly touching the limits of the mandarinate and of localism.
Over the course of the Covid crisis, presented by Emmanuel Macron as a “Great scientist”, Didier Raoult has become a figure of scientific populism. Like Claude Allègre before him on the climate issue, but with a power multiplied by his YouTube channel, social networks and obliging media, he was able to spread his word without the intermediation of the academic debate. His successors will have to settle this cumbersome legacy.