The IHU of Marseille and its former director Didier Raoult again pinned. A report of the General Inspectorate of Social Affairs (Igas) and of theGeneral Inspectorate of Education, Sport and Research (IGESR), published Monday, September 5, “highlights serious malfunctions” within the Mediterranean Infection University Hospital Institute (IHU-MI), created in 2011 and directed by Professor Didier Raoult until the end of August.
The Minister of Higher Education and Research, Sylvie Retailleau, and the Minister of Health, François Braun, seized the Marseille prosecutor’s office. “Several elements contained in the report [sont] likely to constitute offenses or serious breaches of health or research regulations“, they said in a joint press release. Faced with the seriousness of the facts, the two ministries decided to convene the new management of the IHU “in a few weeks”.
Franceinfo takes stock of what Igas and IGESR blame the IHU and its former leader in their report, written after some 300 interviews with employees. This document covers a wider field than a previous report, already scathing, published a few months ago by the Medicines Agency (ANSM) and for which the Marseille public prosecutor’s office opened a judicial investigation on Tuesday, September 6, in particular for false in writing.
“Deviant” medical and scientific practices
The report points “certain medical and scientific practices (…) not complying with the regulations in force and which may generate a health risk for patients”. The inspectors note in particular that patients treated at the IHU for Covid-19 or tuberculosis were administered “molecules outside their marketing authorization”. This concerns, for example, the famous treatment based on hydroxychloroquine, banned since May 2020.
Since the start of the pandemic, Didier Raoult had promoted this drug, thus acquiring worldwide notoriety, despite the demonstrated ineffectiveness of this drug against Covid-19. According to the report, doctors at the IHU reported“a dogma and a desire to go against national and international recommendations”. For other interns, while there was not necessarily an obligation to follow these internal protocols, in practice there was “strong pressure to do so”.
A scientific strategy to review
For clinical research, the report denounces “serious shortcomings (…) until a very recent period (end of 2021 – beginning of 2022)” : several studies have thus been conducted without respecting the provisions of the public health code for research involving the human person. From a scientific point of view, the report also denounces bad practices: the IHU teams were in a “Run to publication strategy”but in low-quality journals.
The mission of the ministries also points to an isolation of the IHU, reinforced by the Covid-19 crisis. Thus, the Institute has only responded to seven calls to participate in national projects since 2016. “The IHU does not position itself on major national calls for projects, and it is not requested by the national level despite its technological and scientific capacities”, insists the report. This isolation “strong risk of penalizing the quality of its work”.
Management excesses
Of the “drifts in management practices that can generate harassment and ill-being at work” and “drifts in governance” were also observed. The report also confirms that doctors at the IHU were pressured by their management to prescribe thehydroxychloroquineor ivermectin, another drug whose anti-Covid benefits have never been proven.
Clinical research, already scratched, was carried out in a biased way, again under pressure from management. Young researchers came to “voluntarily water down the results and data or remove things that don’t work, so as not to be pressured”, according to the report. The mission “recommends renewing the IHU’s medical management team and profoundly modifying managerial practices”.
The document evokes, more broadly, a very authoritarian functioning with a Didier Raoult “omnipresent”leaving “little room for contradiction” and “a logic of submission”. Retired since the summer of 2021 from his post as a university professor-hospital practitioner, Didier Raoult has recently left the head of the IHU Méditerranée. Since September 1, the institute has been led by Professor Pierre-Edouard Fournier, an infectious disease specialist from the institution who worked under the aegis of Didier Raoult. His appointment had drawn criticism, both internally and externally, as not marking a sufficient break.
A deteriorated financial situation
According to the report, the financial situation of the IHU is still healthy, “but she’s deteriorating”. Operating revenue is in “small decrease since 2017”, from 7.9 million euros to 7.3 million euros. On the other hand, total operating expenses increased, from 7.2 million euros in 2017 to 8.8 million euros forecast for 2022, “an increase of about 22%”. “One of the new director’s priorities will be to work on a new realistic economic model”says the report.