Concerns over dozens of papers from Marseilles medical institute

A major journal publisher has put warnings on 49 articles linked to a French research institute under investigation over concerns about illegal research practices. 

The US publisher Plos has put interim expressions of concern on articles by researchers from Marseilles’ University Hospital Institute Méditerranée Infection (IHU), which is under criminal investigation for work carried out under former director Didier Raoult, known for his embrace of an antimalarial as a treatment for Covid-19. 

The flagged articles include 28 in the publisher’s flagship Plos One journal, 19 in Plos Neglected Tropical Diseases and others in Plos Genetics and Plos Pathogens. The notices follow a year-long investigation and warn readers about concerns over ethical approvals, among other issues. 

In a statement, Plos said its ongoing investigations involved more than 100 articles linked to IHU or Aix-Marseille University (AMU), and had found reused ethics approval reference numbers in “many” articles and undeclared conflicts of interest with pharmaceutical companies. The output of some of the authors involved was equivalent to roughly one article every three days, raising questions about their actual contributions, the publisher added. 

France’s research and health ministers, Sylvie Retailleau and François Braun, requested an investigation into IHU in September 2022, after France’s medicines regulator found “serious shortcomings” that put patients at risk. “Criminal” practices listed in the regulator’s report include a tuberculosis test that was trialled on minors and homeless Romanian men who spoke no French but who supposedly still gave informed consent for the study. 

Many of the Plos papers count the controversial microbiologist Professor Raoult as a co-author. He rose to fame during the Covid-19 pandemic for pushing hydroxychloroquine as a treatment for Covid, despite a lack of evidence for its efficacy. 

France’s medicines regulator found that the institute’s protocols from May 2022 still called for Covid-19 treatment with hydroxychloroquine, despite a two-year-old ban on such uses of the drug. Professor Raoult, who had led the institute’s research unit since its founding in 2011, left his post at the end of August. He has been replaced by Pierre-Edouard Fournier. 

In 2021, Professor Raoult’s publications featured as a research subject in a Plos Biology paper looking at hyperprolific authors, which found he had co-authored 32 per cent of the 728 papers published by the Elsevier title New Microbes and New Infections. The journal’s editor and six associate editors – who collectively accounted for 44 per cent of all its papers up to June 2020 – worked directly for Professor Raoult, the study found. 

Plos said it had so far finished initial assessments of 108 articles and would contact the authors of all those affected. “We anticipate it will require at least another year to complete this work,” it said in a statement.

Responding to the Plos warnings, Professor Raoult told Times Higher Education they were part of an attack by “American officials”, acting on behalf of the pharmaceutical industry, which was upset at his advocacy of “cheap compounds such as chloroquine”.

He dismissed the concerns about conflicts of interest in the work he oversaw at IHU and said ethical approval was not needed for studies using patient stool samples, citing rules derived from Roman law. “When Plos asked [for] an explanation, we did this each time, even when it was esoteric, [like] asking for informed consent from apes or lice,” he said.

Also responding to the concerns, current IHU director Professor Fournier told THE that government inspectors had not raised any concerns about the Plos articles and that AMU had subsequently begun its own probe of the papers.

He also dismissed the claims of conflict of interest, which he said related to a now-defunct start-up company, which had brought no financial benefits to the authors. Responding to the allegation of reused approvals, he said they had been issued for an entire strategy rather than individual studies.

“I am extremely concerned by such a decision made by the Plos group that may impact especially young researchers, and I really wish to initiate a constructive discussion with them,” he said.

ben.upton@timeshighereducation.com