Several politicians have resigned and a university has been suspended from doing clinical trials. Lucien Chauvin reports from Lima.
In an escalating scandal involving the misuse of COVID-19 vaccines, Peruvian President Francisco Sagasti has publicly expressed a sense of betrayal at Cabinet ministers who were secretly vaccinated against the virus.
In August, 2020, Peru's Government asked Sinopharm to supply additional doses of its BBIBP-CorV vaccine that was going to be tested in the country. Sinopharm, which eventually included close to 12 000 people in its clinical trials in Peru, agreed.
In mid-February, 2021, former President Martín Vizcarra claimed that he had taken part in Sinopharm's trial, and that he, his wife, and an older brother received the vaccine and its booster in October, 2020. Vizcarra, who was impeached 3 months ago and is now running for Congress, said that he was like thousands of other Peruvians who took part in vaccine trials—but that was not true. Trial managers confirmed that Vizcarra was vaccinated, but not as part of the trial. Instead, Vizcarra and around 500 others were secretly vaccinated months before Peru began its inoculation campaign.
“The impact is bad, no matter how you look at this”, said Víctor Zamora, a public health expert and former health minister. “I don't think there is a sector in the country that does not feel betrayed by this.”
It is easy to understand the anger, given the death toll and economic cost of COVID-19. Peru's Ministry of Health reported 187 deaths on Feb 20, 2021, bringing the total to 44 877 over 11 months. In Latin America, Peru is behind only Brazil in per capita deaths from the virus, according to Johns Hopkins University's COVID-19 tracker. The country's economy contracted by 11% in 2020, and unemployment is at 13%.
Health Minister Pilar Mazzetti and Foreign Affairs Minister Elizabeth Astete were also secretly vaccinated. They have now resigned, as have dozens of people who worked for them. Sagasti has said that he cannot fathom why the ministers lied. He told CNN that he was so disappointed and angry with Mazzetti that he had consulted with psychologists to try to understand her actions.
The problem goes beyond the president's disappointment. The Ministry of Health asked for the extra vaccines and the Ministry of Foreign Affairs channelled the request. According to an initial inquest, 2000 doses went to the Ministry of Health and 1200 to the Chinese Embassy in Peru. The embassy did not respond to questions about the doses it received.
These two ministries have been in charge of Peru's negotiations for clinical trials and agreements to acquire vaccines. Clinical trials of Sinopharm's BBIBP-CorV vaccine were the first to be approved in Peru. BBIBP-CorV was also the first COVID-19 vaccine approved for use in Peru. CureVac, Janssen, and Oxford University–AstraZeneca are also testing vaccines in Peru. Peru has deals to buy 38 million doses from Sinopharm—with 1 million delivered as of Feb 13, 2021—in addition to 20 million from Pfizer, 14 million from AstraZeneca, and 13·2 million through the COVAX Facility.
The new health and foreign affairs ministers are investigating, as are the Attorney General, Comptroller General, and Congress. Oscar Maúrtua, a former foreign affairs minister and head of the Peruvian International Law Society, said Peru needs to clear up the problem quickly before it undermines governance and affects international relations. “This is a grave crisis that has again shined a light on the serious problem of corruption that affects Peru.”
A further controversy, and one that has experts perplexed, was the decision by trial administrators at the Cayetano Heredia University, a leading private university in Peru, to give three doses to at least 40 people. Zamora called the application of a third dose “unethical, violating the most basic protocols of studies and international agreements”, such as the Declaration of Helsinki.
Germán Málaga, who ran the study for Cayetano Heredia University and has been suspended pending the investigation, defended his actions, arguing that “many experts are now talking about need for an additional booster for the COVID-19 vaccine and companies like Pfizer and Moderna are talking about boosters”. He added that he decided to administer a third dose “thinking as a doctor, not as a researcher”.
Angela Uyen, who studied at Cayetano Heredia University and now works for Médecins Sans Frontières, said the case would “affect research in Peru, impacting the level of confidence international stakeholders have regarding Peruvian regulation and the ethics of researchers”.
On Feb 19, 2021, the National Institute of Health suspended the unit doing the Sinopharm trial at Cayetano Heredia University from doing clinical trials. The university's president, Luis Varela, and two deans resigned the same day. Uyen said that, if authorities made a quick decision, some good could come from the crisis, getting Peruvians to understand the relevance of clinical trials and encouraging changes in the approach to research. “Maybe we can use this as an opportunity to strengthen our research processes and get ready for future experiences that will require accelerated action”, she said.
This online publication has been corrected. The corrected version first appeared at thelancet.com on May 13, 2021