Damning reports are piling up on the offices of the IHU Méditerranée infection and those of the administrative and criminal authorities. After that of the National Medicines Safety Agency (ANSM), which placed the Marseilles institute under supervision last June, it is the turn of the General Inspectorate of Social Affairs (IGAS) and the General Inspectorate of Education, Sport and Research (IGESR) to crush the IHU.
This document, consulted by La Provence, confirms that the Marseille IHU has been the scene of many abuses for years, both socially and health-wise. This is a provisional report, since it is in the contradictory phase: the IHU still has time to respond to the problems raised and to correct them before the publication of the final report. However, even if the management agrees to reform itself in depth, as affirmed by Pierre-Edouard Fournier, probable and already disputed successor to Didier Raoult, it will probably take more than a few weeks, both the list of dysfunctions pointed out by the IGAS is long.
On management, IGAS and IGESR describe, as in a previous report – published in 2015 but inexplicably forgotten – the extreme concentration of power in the hands of an “omnipotent” Didier Raoult, as well as the absence of counter-power. Director of the IHU, member of the board of directors where almost only relatives sit, he thus controls all the services, from research to training through care. The IGAS denounces a management “by terror” and a “logic of submission” of the staff.
The IGAS indicates that the debate or the contradictory only rarely has its place within the IHU, confirming the remarks reported in a previous survey by L’Express. “There is a whole part of the IHU that operates in a vacuum, with a leader who is never contradicted and who exercises real influence, who does not hesitate to crush and publicly despise those who are not d ‘agreement with him’, denounced for example an employee of the IHU. A complaint far from being isolated, according to the hearings conducted by IGAS, since of the 300 employees or former employees questioned by the inspectors, around fifty reported “a situation ranging from discomfort to great suffering linked to their professional activity. All requested anonymity, fearing professional reprisals.
The health component is no more tender, since it shows that patients treated at the IHU receive “prescriptions which do not respect the code of public health, which is likely to fall under a criminal qualification” , according to the report consulted by La Provence. Thus, the hydroxychloroquine-azithromycin-zinc combination, a treatment whose ineffectiveness has been demonstrated by numerous scientific studies, is still prescribed to IHU patients suffering from Covid-19, despite the ban pronounced by decree in May 2020. Ivermectin, another treatment whose effectiveness has never been proven, is also prescribed there.
Again, the report confirms the words of an employee interviewed more than a year ago by L’Express. “Today, if you come to the IHU for Covid-19, you will still be given hydroxychloroquine with azithromycin and zinc, she confided. Doctors who do not prescribe it are few because they are afraid that the internal software of the IHU – which allows the management to follow the prescriptions – will betray them… And those who really do not want to prescribe write false declarations in this software, in order to ‘to have peace”. The IGAS report reveals that these pressures go even further, since doctors who refuse to prescribe these treatments are sharply criticized by their leaders. “When I no longer wanted to prescribe, I was offered pre-stamped prescriptions,” says another practitioner. Facts which are also “likely to fall under a criminal qualification”, warns the IGAS.
These investigations also confirm the observations of the ANSM concerning the treatment against tuberculosis prescribed at the IHU and revealed by Mediapart. Six out of 35 patients had serious adverse effects. “The question of the loss of opportunity arises”, write the inspectors, who add that these facts are, once again, “likely to fall under a criminal qualification”. The informed consent of several patients, including minors and non-French speakers, was also not always respected. More generally, the IGAS calls into question the quality of the care received at the IHU, provided according to methods that do not comply with standards, are dated or even “obsolete”. Logical conclusion, but scathing for the IHU, the report recommends “retaining Nice as the only regional center for antibiotic therapy and good use of antibiotics in Paca”.
On a scientific level, the report sharply criticizes the bad practices of the IHU. Its teams indeed publish a very large number of scientific studies, but too often in mediocre journals, thus confirming two investigations by L’Express. Between 2012 and 2021, 6790 scientific articles were produced by the IHU, i.e. 679 per year. “A race strategy for publication” denounced by the IGAS, which notably makes it possible to artificially inflate the H-Index of its members – an index wrongly presented as testifying to the quality of a researcher -, but also to win millions euros of public money.
Worse, this research is often conducted in a biased manner, under pressure from management. Young researchers claim to have “voluntarily watered down the results and data or deleted things that don’t work, so as not to be pressured”, reports La Provence. More generally, the ethics and integrity of the IHU are widely called into question, far from the standards in force. “It’s a world of cowboys who tweak their studies,” a source close to these investigations told L’Express.
The vitriolic reports of the ANSM and the IGAS, to which will be added the investigations of the Health, Safety and Working Conditions Committees (CHSCT) of the various supervisions of the IHU, will come to pile up on the offices of the Public Prosecutor of Marseilles, seized by the ANSM, which will have to settle the penal questions. The future of the IHU and Didier Raoult is therefore likely to be even more eventful.
