Developing medications to support COVID-19 treatment

These drugs are an important complement to existing vaccines in the prevention and control of the pandemic. Vietnam’s access to drug research may have been slower than that of some other countries in the region, but it is full of potential, especially regarding drugs from medicinal herbs.

Initial success in researching antiviral medications

Soon after COVID-19 broke out in Vietnam, Assoc. Prof. Dr. Le Quang Huan and coordinators at the Institute of Biotechnology (Vietnam Academy of Science and Technology) got down to researching SARS-CoV-2 antiviral drugs from herbs which have a strong binding effect on molecules involved in the invasion and proliferation of the coronavirus. So far, the team has created hard capsule products.

The results of preclinical studies show that the products are safe and effectively inhibit the replication of H5N1 and SARS-CoV-2, while enhancing immunity in experimental research models. The research team is proposing to the Ministry of Health for clinical trials on COVID-19 patients. Huan said that the team used new biotechnology to screen 28 main active ingredients in herbs that work by different mechanisms, such as blocking S protein of SARS-CoV-2, specifically ACE2 on the host cell, to prevent virus contact and entry into the cell; inhibitting enzymes involved in viral replication; and activating the patients’ immune system cells. These mechanisms have a synergistic effect to funtionally prevent and support the treatment of COVID-19.

According to Huan, Vietnam’s successful culture of SARS-CoV-2 has opened opportunities for the research and development of COVID-19 prevention and treatment drugs, and the team’s research results are the first products tested on SARS-CoV-2.

A number of institutes and enterprises have also started researching antiviral agents against SARS-CoV-2 from natural and synthetic sources. The Institute of Medicinal Materials has compiled and introduced 71 medicinal materials, herbal plants, and traditional medicines used to support the prevention and treatment of SARS-CoV-2, and will add information on 100 herbal medicines and plants. Assoc. Prof Dr. Nguyen Minh Khoi, Director of the Institute of Medicinal Materials, said that the unit has been actively carrying out research to discover active ingredients against SARS-CoV-2 and enhance immunity, and has submitted a registration profile for capsules of Andrographis Paniculata (commonly known as green chiretta), a herbal plant extract, and tablets of health protection product COVINIMM so that they may be produced to serve pandemic prevention and control.

The Institute of Chemistry (Vietnam Academy of Science and Technology) has successfully studied the process of synthesising Favipiravir drug ingredients and continued to perfect and scale up the synthesis process. Meanwhile, the Vietnam Academy of Traditional Pharmacy and Medicine has determined its plans to research antiviral drugs against SARS-CoV-2 and COVID-19 treatment support medications. Nanogen Pharmaceutical Biotechnology JSC is researching monoclonal antibodies to treat COVID-19.

In addition, management agencies have implemented a range of activities to promote the strengths of traditional medicine in COVID-19 prevention and treatment. The Administrtion of Traditional Medicine (Ministry of Health) has consulted with leading experts in traditional medicine and agreed to offer 15 products to support COVID-19 treatment according to each stage of the disease. Up to now, it has provided these products in service of fighting the pandemic in several hot spots, such as Bac Giang, Bac Ninh, Ho Chi Minh City, Binh Duong, and Dong Nai, and has guided drug use establishments to monitor and evaluate the effects of drugs.

During the COVID-19 outbreak in the northern province of Bac Giang, with the consent of the Ministry of Health, the Bac Giang Traditional Medicine Hospital and the Vietnam Academy of Traditional Pharmacy and Medicine used the remedy “Ngan Kieu Tan” in the form of decoction to assist the treatment of patients. According to preliminary follow-up data, the number of patients turning severe declined remarkably compared to not taking this drug.

An overall scientific strategy and specific policies needed

According to scientists, despite its huge potential, Vietnam's access to drug research and production is generally slow in comparison with other countries in the region. Assoc. Prof Dr. Nguyen Duy Thuan, former Deputy Director of the Vietnam Academy of Traditional Pharmacy and Medicine, said that right from 2020, researchers in many countries and territories such as China, India, Singapore and Taiwan (China) were interested in using herbal medicines to support the treatment of COVID-19.

Accordingly, they processed some traditional remedies treating common colds into various forms and studied how to develop them into COVID-19 treatment support drugs. Scientists around the world have researched and published more than 30 active ingredients from herbs that have the effect of inhibiting the replication of SARS-CoV-2, some of which are extracted from medicinal herbs available in the country, such as andrographolide, berberin, curcumin, artemisinin, and baicalein.

Notably, andrographolide – a substance found in green chiretta – has been widely used by Thai scientists in COVID-19 prevention and control. On that basis, the Thai Ministry of Public Health has recommended using it independently or in combination with other effective drugs to treat SARS-CoV-2.

Amidst the emergence of many new COVID-19 variants, medications are an important complement to existing vaccines for pandemic prevention and control. Therefore, it is necessary to promote the research and production of COVID-19 prevention and treatment support drugs. The head of the Adminsitration of Traditional Medicine said that the use of traditional medicine in preventing and supporting the treatment of COVID-19 is of extreme necessity. The unit has coordinated with the Administration of Science, Technology and Training (Ministry of Health) to develop specific plans to create conditions for businesses when submitting products to the ministry for assessment.

Instead of just relying on research institutes, scientists or businesses, management agencies should have an overall scientific strategy and specific mechanisms, while requesting or ordering scientists to research drugs as well as mobilising resoures for drug research, production and clinical trials.