As their high school reopened after being closed for a month due to the coronavirus, students in Madagascar's capital city were given face masks and a small bottle of an herbal extract they were told to drink to protect them from COVID-19.
Many grimacing at its bitter taste, the students swallowed the drink and entered school to resume classes, where they were now seated one to a desk instead of two, for safer distance.
Madagascar's President Andry Rajoelina promoted the drink, Covid Organics, on national television saying it will "change the course of history."
There are no approved drugs for COVID-19 and numerous treatments and vaccines are currently being tested around the world.
Madagascar, an Indian Ocean island nation of 26 million people, currently has 128 recorded cases of Covid-19 and no deaths.
The herbal drink has not been scientifically tested and there's no proof it works against COVID-19. But the president is enthusiastically promoting it.
"What we want to do today is to popularize this drink to protect our population," said Rajoelina on television and then drank a bottle of the concoction.
The drink is being distributed for free in some schools that are reopening and in poor neighborhoods. Elsewhere it is being sold for about 30 cents for an 11-ounce bottle.
The drink was developed by the Malagasy Institute of Applied Research, a private organization that for more than 30 years has researched the uses of Madagascar's traditional medicines. The label on the bottle does not list the ingredients but the president said it is made from artemisia, a bitterroot that is used in some malaria drugs.
Medical experts are critical of the drink, pointing out that no scientific tests have been done on it.
"The scientific evidence that this is effective has not been proved. It's likely that it could actually harm the health of the population, particularly that of children," said the president of Madagascar's Academy of Medicine, Marcel Razanamparany, in a statement.
With no approved drugs for COVID-19, some people around the world are resorting to unproven therapies, sometimes with the backing of government leaders. Rigorous testing of herbal and other traditional remedies is needed, say experts.
The U.S. National Institutes of Health has warned against alternative medicine — including certain herbal therapies and teas — for treating or preventing COVID-19, saying there was no evidence they work and some may be unsafe.
"It's the responsibility of those who make a herbal drink to show the scientific evidence that their claims are valid," said Dr. Stephen Barrett, a retired psychiatrist who runs Quackwatch, a website about unproven medical therapies.
"This is a worldwide problem, with untested products being promoted as cures," he said. "The money spent producing this might be better spent in Madagascar vaccinating children against measles and other childhood diseases."
Madagascar is currently battling an outbreak of measles, which last year killed nearly 1,000 children.
In Madagascar, the herbal drink was developed in recent weeks and will also be sold in larger 1-liter bottles for the equivalent of 80 cents and as tea bags for $2.60 for a box of 14.
In front of the Ampefiloha high school, in the center of the capital Antananarivo, hundreds of students in their final year, took the drink in order to return to class.
"I was a little afraid of this remedy at the beginning but I saw a program on television where the president of the republic drank it so I am no longer worried," said Hugo Ramiakatrarivo. "They say it boosts immunity, but I don't know if it will work. My parents told me not to take this medicine. They even told me not to go to school today because the epidemic is not over and especially not to drink this medicine. They are really scared. But I decided to come to study because we have our exam at the end of the year."
Classes were suspended on March 23 by the Malagasy authorities after the announcement of the first cases of COVID-19 in the country.
The school's principal, Mamisoa Randrianjafy, reassured skeptical students.
"It is an herbal tea as we are used to taking," he explained, saying it is like many other herbal remedies popular in Madagascar. He said that if students refuse the drink, they would not be permitted to attend classes.
The secretary general of the Ministry of National Education, Herimanana Razafimahefa said the drink will be given to all students in the capital and two other cities where COVID-19 has been confirmed.
At the Ampefiloha high school, Déborah Andrianary, 19, took a few sips of the drink.
"It's bitter and a little sweet at the same time, so it made me want to throw up," she said. "I'm not afraid to drink it because I'm used to herbal teas, but the taste is really weird. I don't know if I'm going to finish this bottle."