What the Ivermectin Debate has revealed to us in a Time of Pandemic, was the title of a webinar facilitated by Professor Colleen Aldous, from UKZN’s College of Health Sciences. It featured panellists Professor Anisa Mosam Associate Professor: Dermatology; Mr Andrew Gray Senior Lecturer: Pharmacology, and Dr Warren Parker, public health and communication specialist.
Introducing the webinar, Aldous remarked that, ‘The Ivermectin debate has polarised both the lay and the scientific communities and damaged the relationship between science and society.’
Mosam noted that, as a drug initially used for veterinary purposes to treat parasitic activity, Ivermectin earned the title of being a blockbuster drug due to its success and was later introduced to humans to treat cases of tropical dermatosis. Labelled as an ideal drug by some because of its affordability, safety, and tolerance and the fact that it has proven effective against drug resistance, Ivermectin has been listed as one of the World Health Organization’s (WHO) essential medicines, with more than four billion doses administered worldwide.
Mosam described some of Ivermectin’s properties, including its anti-parasitic, antibacterial, anti-cancer and antiviral functions. She noted that, ‘based on its antiviral capabilities and anti-inflammatory activities it has come up as an agent that can be active or might be useful in the fight against COVID-19.’
Gray focused on the selection and regulation of medicine in South Africa and explained the drug management cycle.
He noted that the selection of essential medicine has changed during the COVID-19 pandemic and that attempts were being made to fast track reviews of evidence. ‘This entire process started because of the demand that was being felt in the country for access to chloroquine early in March 2020 and when that evidence was reviewed a recommendation was made not to include chloroquine in the public sector.’
Gray said that the South African Health Products Regulatory Authority (SAHPRA) is ‘an independent national medicines regulatory authority responsible for medicine for both humans and animals, medical devices and clinical trials.’ He noted Section 21 which allows access to unregistered medicines for individual patients if motivated by their physician or for clinical trials and observed that SAHPRA’s assessment of medication is centred on quality, safety and efficacy.
Drawing a link between his experience in ensuring that the wearing of face masks became public policy and looking at Ivermectin as a possible therapy for COVID-19, Parker examined the context of the drug in South Africa and added that the public’s uncontrolled usage of Ivermectin was evidence of their lack of trust in the state’s epidemic response.
He reviewed evidence on the use of Ivermectin in COVID-19 treatment and argued that it includes a high safety profile; fits the rationale for repurposing and the bioethical rationale for COVID-19 treatment; has confirmed positive effects from numerous peer reviews; and has been approved for compassionate use by the SAHPRA.
Considering how exceptionalism (where Ivermectin has been set at a higher bar than other therapies), elitism (dismissal of research not from Western universities or funded by drug companies) and conservatism (the lack of critical thinking in a severe epidemic) have hindered the use of Ivermectin, Parker said, ‘Taking all factors into account, the urgency, uncontrolled use, new variants, third wave, vaccine challenges, risks and the totality of evidence, we need to seriously consider Ivermectin.’
Words: Hlengiwe Khwela