In January 2024, L’Express reported the publication of a new study on hydroxychloroquine. This proposed for the first time an estimate of the number of deaths caused by the use of this drug, wrongly used against Covid-19. “Proposed”, because on August 26, 2024, seized with doubts concerning the reliability of the data used, the publisher Biomedicine & Pharmacotherapy abruptly decided to retract it, provoking strong questions within the scientific community.
The study estimated at 16,990 the number of deaths linked to the massive use of hydroxychloroquine under the unfounded recommendations of Professor Didier Raoult, for the period from March to July 2020 alone. Now crossed out from page to page on the journal’s website, this work, covering six countries (Belgium, Spain, Italy, Turkey, the United States and France) and based on the number of hospitalizations as well as an approximation of the risk and the prescription rate of the molecule, is therefore officially no longer relevant.
Except that, something that is extremely rare in the scientific world, many specialists are contesting this decision. “There is, to my knowledge, no reason to proceed with a retraction,” says Bernard Bégaud, one of the pioneers of pharmaco-epidemiology in Europe, the discipline in which the repealed works fall.
“Such motives are scandalous”
The most severe sentence against scientific work, retraction is usually reserved only for fraud or data manipulation. Journals may possibly proceed with retractions in the case of significant errors, but these cases are very rare. “For this to happen, the errors would have to have led to a misinterpretation in the demonstration and in the conclusions of the article, which is not the case here,” continues the specialist.
The full reasoning of the review has not been made public. A summary in an explanatory note simply states that the data used, “in particular those from Belgium,” had proven insufficiently reliable. In the absence of precise measurements, the authors had also used average values to estimate the dosages of hydroxychloroquine administered, an assumption deemed “incorrect” by the publisher.
Criteria that are too light according to many specialists. “The authors provided an approximation with data that are certainly imperfect, but relevant given the lack of information at the time,” believes Antoine Pariente, director of the Department of Public Health at the University of Bordeaux. “Any estimate is based on hypotheses and a certain degree of uncertainty. Such motives are scandalous,” adds Francesco Salvo, head of the pharmacovigilance center at the University Hospital of Bordeaux.
Intimidating and insulting emails
In fact, for these experts, the approximations pointed out by the journal do not seem to call into question the general conclusions. “If we redo the calculations taking into account the remarks, the result remains of the same order of magnitude, between 6,000 and 20,000 deaths, as the authors had specified”, continues Bernard Bégaud. On the other hand, the weaknesses criticized had not been hidden: they had been indicated in full in the article and were taken into account in the estimates.
In light of these elements, many doubts have been raised as to the real reasons for the retraction. Having become the symbol of the dangerousness of Didier Raoult’s claims, the study has been the target of great pressure from hydroxychloroquine activists. Convinced that the molecule remains the “miracle cure” that they were promised, these activists, still very active in France, flooded social networks with injunctions to retract this work, as soon as it was published. It was also these same networks that announced the retraction in France. Didier Raoult did so on August 18, a week before the decision became official, in a live of the speaker Idriss Aberkane.
In addition to sending dozens of intimidating and insulting emails to the study’s lead author, Professor Jean-Christophe Lega, the most virulent supporters of the former director of the Marseille University Hospital Institute, led by mathematician Vincent Pavan, went so far this winter as to infiltrate the University of Lyon I, where Professor Lega works. As a sign of the importance that the case has taken on, far from being confined to simple online grumbling, the university reported the facts to the public prosecutor and placed the researcher under functional protection, legal assistance provided to civil servants in the event of aggression or legal attacks.
The pro-Raoult and Xavier Azalbert networks
Also targeted online, the magazine has never publicly reported these abuses. At least, not in these terms. In its note, Biomedicine & Pharmacotherapy said it had learned of the existence of a “debate” among its readers about the study. And this, through the letters that it indicated it had received in very large numbers. The journal had also initially opted for a simple publication of these documents accompanied by a response from the scientists. Then, it suddenly changed its mind, in view of the “scale and importance” of the complaints.
“Letters to the Editor”, as they are formally called, are the main, most official, supports of scientific controversy. Just like research articles, researchers must submit them to peer review in order to verify the validity of the reasoning contained therein. According to Jean-Christophe Lega, Biomedicine & Pharmacotherapy retained nine of them. “Most of them were extremely accusatory in tone and of such a low standard that they seemed unpublishable to me,” says the researcher, who was deeply affected.
L’Express was able to consult two of these letters. first was signed by Jean-Michel Dogné, a specialist in a discipline close to that of Jean-Christophe Lega. The second, for its part, is only scientific in appearance: it was published in a predatory journal and its first author is Xavier Azalbert, director of the conspiracy site France Soir, spearhead of French disinformation, stripped of his title of press organ and awaiting an appeal to the administrative court. The man, one of the most committed detractors of the study, is however neither a researcher nor a scientist.
Disturbing details
Biomedicine & Pharmacotherapya general journal whose management and review committee do not contain any French people, could it have been influenced by these false claims and a lack of awareness of the tension that persists in the country around hydroxychloroquine? When contacted, the publisher refused to say more. “We support the retraction and the principle of peer review,” said a spokesperson for the title’s parent company, Elsevier. One thing is certain: these untimely letters are not the only pressures it has been subjected to. In addition to producing false arguments, Xavier Azalbert also sent a legal notice to Biomedicine & Pharmacotherapyand the has then published online.
Contacted by L’Express, Xavier Azalbert welcomed the withdrawal of the study, and refuted any harassment or pressure against the journal, believing that his actions in no way undermine the “sovereignty” of the publication. The details of the procedure give another impression: according to Christophe Lega, the journal never asked to consult his data, yet the first thing to do in case of doubts about the validity of a study. Contacted during our investigation, the researcher’s unit manager and the university’s manager in case of ethics problem confirmed this.
Another disturbing detail is that the journal had contacted the Integrity department of the group to which it belongs, Elsevier. But according to our information, it suddenly accelerated the procedure without waiting for a response. “Such haste, without an audit or independent investigation, makes me think that the journal got scared and decided to retract to avoid endless and costly legal proceedings,” believes Hervé Maisonneuve, former president of the European Association of Science Editors, an association that brings together the editors of the main European journals.
Denial of science and heresy trials
The case has caused a great deal of emotion in the world of research. “Few people are aware of what is happening. Harassing academics on the grounds that we do not agree with their work, that they do not defend our beliefs, is a form of coercion through terror, of denial of science. I fear that tomorrow we will be tried for heresy,” worries Professor Mathieu Molimard, member of the board of directors of the French Society of Pharmacology and Therapeutics.
“This retraction is a political decision,” adds pharmacoepidemiologist Bernard Bégaud. “What scares me is that we could replace scientific controversy with popular pressure. If these cases are not taken very seriously by health authorities and scientific institutions, any paper that causes discomfort could be killed with a hyper-mobilized social network and the use of lawyers.”
Cases of retraction under vindictiveness are rare. But several similar scandals have recently broken out. In September 2021, the highly influential group Springer Natureone of the most reputable, retracted a study analyzing the number of predatory journals, under pressure from one of those cited, Frontiers. Faced with the turmoil caused, several members of the journal’s editorial board had then made it known that they were thinking of resigning. They themselves considered the publisher’s decision as a “political” choice, motivated by “economic” interests.
Recent similar scandals
In July 2024, the review Proceedings of the National Academy of Sciences (PNAS), also very prestigious, was preparing to publish a critical letter addressed to the work of Chad Mirkin, an award-winning American chemist. But, alerted by the procedure and furious, he then turned against the publisher, threatening him with legal action. Cornered, PNAS decided not to publish the document and simply asked Chad Mirkin to issue a correction.
These cases illustrate the growing difficulty in producing science, while public debate, in the United States as in France, is fragmented, increasingly intolerant of contradiction. “Science is human. Sometimes, legal, media pressure, reputational issues can prevail, especially since journals are not equipped to fight against harassment campaigns. These are capable of producing very large volumes of false claims very quickly,” summarizes Frédérique Bordignon, a researcher specializing in the analysis of publication practices.
In another genre, a complaint filed by the BonSens association, whose publication manager is none other than Xavier Azalbert, had succeeded in triggering a search in December 2021 at the home of epidemiologist Dominique Costagliola, also a target of pro-Raoult networks. Revealed by L’Express, the case has since been closed by the National Financial Prosecutor’s Office, due to a lack of credible evidence against the researcher.
.