The ivermectin, an anti-parasitic medicine, is sometimes used to treat Covid-19 despite medical recommendations against it. But countries react differently.
On April 7, a South African court issued an order allowing doctors to prescribe medicines that contain ivermectin to be used for the treatment of Covid-19. The judgment states that the South African Health Products Regulatory Authority "is enabling the use of ivermectin for the purpose of treating or preventing Covid-19".
The decision follows a legal action taken by South African healthcare practitioners, a civil right organization, the African Christian Democratic Party or pharmaceutical wholesalers in order to provide access to the medicine.
Some would like ivermectin to be authorized for covid-19 treatment
Ivermectin is used to treat skin conditions like rosacea or scabies and diseases caused by parasites or worms like the ascaris. This compound is on the World Health Organization's list of essential medicines.
However, not all countries approve ivermectin for human use, but the active agent can usually be administered to animals and cattle.
In South Africa, ivermectin was only authorized for animal treatment, and for humans in rare occasions.
But international attention grew on ivermectin as a way to treat Covid-19 in the past months, especially in Latin America and in Asia.
In April 2021, the Philippine authorities insisted that people who would sell ivermectin to humans may face fines or even up to 10 years of imprisonment after that a local pharmaceutical firm applied for a certificate product registration.
South Africa also noticed a widespread unregulated use of ivermectin, either for veterinary purpose or sourced from illegal importation.
According to the BBC, the price of the pills soared 15-fold on the South African black market, despite several major drug regulation agencies advising not to use the active agent outside of the usual authorizations.
Several medical agencies ask not to use ivermectin to treat Covid-19
About 50 studies have been conducted on the ivermectin efficacy around the world so far.
Even Merck declared in February 2021 there was "no meaningful evidence for efficacy in patients with Covid-19 disease". The manufacturer of Stromectol, a medicine approved for human use in the U.S. that includes ivermectin, even highlighted "a concerning lack of safety data in the majority of studies".
WHO has now updated its guidelines of Covid-19 treatments. It considers that "the current evidence on the use of ivermectin to treat Covid-19 patients is inconclusive. Until more data is available, WHO recommends that the drug only be used within clinical trials."
The U.S. Food and Drug Administration warned that some doses can be "highly toxic in humans", pointing out that the ivermectin given to animals like horses or cows should not be used to humans.
They include ivermectin in much greater quantity, along with inactive ingredients with unknown effects when absorbed by humans.
Czechia and Slovakia approved the use of ivermectin against covid-19
The European Medicine Agency also released a statement on March 22, 2021 in which it advised "against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials".
It also noted that in vitro results blocking replication of SARS-CoV-2 were achieved with much higher doses than authorised. Moreover, some studies showed no benefit and others only reported a potential benefit.
As a consequence, the French regulation agency, the Agence Nationale du Médicament, declined a request for a temporary use of ivermectim.
But despite EMA recommendations, Slovakia and Czechia, two European Union members, allowed the temporary use of the ivermectin for Covid-19 treatment within the remit of their national legislation.
Media sources and useful links:
- High court of South Africa, Afriforum, April 2021, Free access
- Update on the use of ivermectin in the prevention or treatment of Covid-19, SAHPRA, January 2021, Free access
- Model List of Essential Medicines, WHO, Free access
- WHO advises that ivermectin only be used to treat COVID-19 within clinical trials, WHO, March 2021, Free access
- Why You Should Not Use Ivermectin to Treat or Prevent COVID-19, U.S. Food and Drug Administration, Free access
- EMA advises against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials, EMA, March 2021, Free access
- Defensor insists on ivermectin vs COVID-19, to give out 'human grade' of veterinary drug, ABS-CBN News, April 2021, Free access
- Illegal to distribute, promote Ivermectin, Rappler, April 2021, Free access
- Ivermectin: South African medics using unproven worm drug to treat Covid-19, BBC, March 2021, Free access
- Merck Statement on Ivermectin use During the COVID-19 Pandemic, Merck, February 2021, Free access
- Ivermectin is effective for COVID-19: real-time meta analysis of 50 studies, IVM Meta, April 2021, Free access