Brazil's health ministry recommended Wednesday using chloroquine and hydroxychloroquine to treat even mild cases of COVID-19, a treatment President Jair Bolsonaro has pushed for despite a lack of conclusive evidence of their effectiveness.
New federal guidelines released by the ministry recommend doctors prescribe the anti-malarial drugs from the onset of symptoms of coronavirus infection, together with the antibiotic azithromycin. Patients will be required to sign a waiver acknowledging they have been informed of potential side effects, including heart and liver problems and retina damage.
The two medications have been swept up in a politically charged debate amid the pandemic. Bolsonaro and his US counterpart Donald Trump, to whom he is often compared, tout them as potential wonder drugs against COVID-19.
Trump even revealed Monday he has been taking hydroxychloroquine daily as a preventive measure. But some studies have cast doubt on the drugs' effectiveness and safety against coronavirus. The health ministry acknowledged that "there are still no meta-analyses of randomized, controlled, blind, large-scale clinical trials of these medications in the treatment of COVID-19."
However, it said the government had a responsibility to issue guidelines using the information currently available. Preliminary studies of the drugs in China and France showed promising results against COVID-19.
However, other studies have cast doubt on their effectiveness and raised concerns about the potential for heart, liver and kidney problems, as well as nerve damage. Brazil's former health minister Nelson Teich resigned last week after less than a month on the job, reportedly after clashing with Bolsonaro over the far-right president's insistence on recommending chloroquine against COVID-19.
Bolsonaro, who has compared the new coronavirus to a "little flu" and railed against social distancing measures to fight it, fired Teich's predecessor, Luiz Henrique Mandetta, also after clashing over how to respond to the pandemic.
Brazil has emerged as the latest flashpoint in the coronavirus pandemic. It registered more than 1,000 COVID-19 deaths Tuesday, its highest yet, bringing its total death toll to 17,971. The country now has the third-highest number of infections in the world, with more than 270,000, behind only the United States and Russia.