Medicine professor slams SA Ivermectin sceptics; many experts aren’t looking at the right data

A black market in Ivermectin has developed, with many South Africans opting for veterinary versions to ward off and stop Covid-19 from developing. Professor Colleen Aldous, a healthcare scientist at the University of KwaZulu-Natal’s School of Medicine, says there is compelling evidence that Ivermectin shows good promise in curing people infected with the coronavirus. Instead of obsessing about human trials to test Covid-19, scientists need to look at the other ways of assessing medicine for use under emergency conditions. She criticises some of the biggest names in SA science circles for having their blinkers on. She spoke to BizNews, about how she moved from being an Ivermectin sceptic to a disciple. The regulatory authority in SA has approved limited use of Ivermectin, but some doctors have complained that their applications for the compassionate use of the drug have not been approved. The South African Health Products Regulatory Authority is reported as telling Parliament that there is not enough evidence on the use of the drug – its safety and efficacy – to treat or prevent Covid-19. – Jackie Cameron

Professor Colleen Aldous on Ivermectin:

Ivermectin came onto my radar [when] a friend of mine who was a farmer send me a WhatsApp that had the details about the experiment that they did in Monash University last year – where they showed that ivermectin, in a petri dish, was able to kill off the virus. This was around October. I did a quick literature search and found the first paper that came up, that said that ivermectin was not effective. So I just sent that back to him. There was a lot of clutching at straws in the beginning of the pandemic.

In December, another friend of mine actually got sick with Covid. He phoned me up and told me that his doctor wanted to put him in hospital – he was so ill. A friend had given him to ivermectin tablets and he’d taken the one. Within 24 hours, he felt completely different. He was well. With my scientist thinking I thought, ‘that’s wonderful for you – great coincidence. You were probably going to get better anyway. I left it at that.

Then I saw this presentation that Pierre Kory had given, and at that point I realised that there’s enough evidence that ivermectin makes an impact [and] that scientists cannot ignore it and we cannot be dismissive of it.

On the effect of Ivermectin on Covid-19:

We’ve got no vaccine that’s going to be 100% effective on the horizon just yet. Before we get herd immunity, it’s going to take us at least a year in a vaccination programme. The vaccination programme won’t be helping public health only by having healthcare workers vaccinated. We have to have a large proportion of the entire population vaccinated before we get herd immunity.

In the meantime, we are going to have a third wave of this disease. We’re anticipating it to be around about April/May into June – and we’re going to get more variants coming through. So everything’s going to get more complex. But we have a drug here that is available. It’s cheap. It can be made in South Africa with compounding pharmacies.

It’s not under patent anymore. It could have a huge impact right, in the beginning of the disease by preventing a measure of transmissibility and preventing people from getting sicker.

On the possible risks of Ivermectin:

There are risks on the black market. Other people have done some tests on some of the black market drugs. Some of have no ivermectin in them at all. So there are people paying hundreds of rands for even one or two capsules and they’re getting nothing. There’s also been tests done that looked at some of these drugs and they’re being contaminated with other drugs.

So the black market has got tablets on it, that are not necessarily all that good for you. The animal preparations are not made for human beings. Dosages and the human response are unknown. But I do know that farmers have been using the veterinary preparations with their workers, too. There definitely is something in it, but I’m not going to say that veterinary preparations are good for human beings – but people have been driven out of desperation to use them. They must be very careful because some of the excipients in these animal preparations could be harmful.

On Ivermectin in South Africa:

SAHPRA has given a controlled access to ivermectin. Earlier in February they announced that they would allow Section 21 applications. In their guidelines, they said they would give a 24-hour response. This, unfortunately, hasn’t happened. If they stick to their word and do give Section 21 applications a 24-hour turnaround, we’re okay in South Africa for now because SAHPRA is a regulatory body.

If they’ve got rules and regulations, they have to stick by them. If they’re going to insist on big randomised control trials, they’re going to wait a very long time. Just to paint the context of why they’re going to wait a very long time, is that nobody last year even thought about having randomised controlled trials for any of these drugs. They were just going into their wards and looking at what drugs worked.

If they found a drug that worked, they did a descriptive study and published it. That’s why we’ve got senior scientists saying there’s not enough evidence – there’s a lot of evidence out there. It’s just that there’s an academic snobbery on the level of evidence and where the evidence is coming from. The papers are all coming from countries who had access to ivermectin because they have parasitic diseases.

We could never have done a trial in South Africa because ivermectin is not legal for human use here. But it’s been used in Bangladesh, Egypt, Nigeria and South America. The trials are coming from there. A lot of people are turning their noses up at that research. That research does give us some evidence on which to build evidence-based medicine. But the rules are such that some people want large, randomised controls and they’re just going to have to wait for them.

I believe the Bill and Melinda Gates Foundation is starting a large, randomised controlled trial across three continents and hopefully will have some results in a few months. In the meantime, we just have to put up with Section 21 applications in South Africa. This goes beyond South African borders. There are other countries that don’t have access to ivermectin. this particular medication could turn the tide, globally, on this pandemic.

On scepticism around Ivermectin:

There a lot of scientists who, I could either say are brainwashed into thinking that the only evidence for medicine is a randomised control trial, or they feel that there have to be sceptical about everything because that is their position. But there are so many other designs that provide research evidence for medicine. I really believe that people – especially the senior scientists – should open their minds and apply some wisdom, into looking at what research has already been undertaken.

I do believe we need more research. There is no formal dosage for Covid. We need dose response studies. We definitely need PKPD studies. But we do not need any more large, randomised controlled placebo trials to show safety or efficacy. That is a waste of time [and] a waste of resources. We must put our energy into looking at how to incorporate this drug into a regimen for Covid-19 treatment.

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