Letter of the Day | Why the resistance to Ivermectin?
THE EDITOR, Madam:
For several months, there has been a sustained call from doctors for the use of Ivermectin in the treatment of COVID-19. In Parliament on June 15, Minister of Health and Wellness Christopher Tufton responded to questions previously tabled by the Opposition. He repeated the ministry’s position, based on WHO advice, not to include Ivermectin in its formal treatment protocol. WHO says ‘no’, so we say ‘no’. That should probably be the ministry’s short, simple, though unsatisfactory answer.
However, in the course of answering the questions and the discussion that ensued, the minister attempted to explore and defend the reasons behind the WHO’s advice and, in doing so, opened the door to continued challenge.
1. Safety – The minister stated that a conservative position is being taken to guard the Jamaican public against the possible dangers involved in the use of Ivermectin. The reality is that Ivermectin is a safe drug – safer than penicillin and the other antibiotics in common use, safer than aspirin and, the data suggest, safer even than Panadol. And, without doubt, safer than Remdesivir, which the ministry has approved. The safety issue should be put to bed.
2. Efficacy – Although there is a difference of opinion on this aspect, most of the studies to date show some degree of efficacy against COVID-19. Depending on the type of study, its size, limitations and constraints, the power of its conclusions may vary. Some speak with a louder voice than others, but all point in the same direction – positive for efficacy. At the very least, the evidence indicates a possible significant benefit.
3. Importation – The minister reiterated that the Government, while declining to include Ivermectin in its formal protocol, has no objection to importation through private agencies. Suitable applications call for adequate information to be supplied to the Standards and Regulations Department of the ministry, to show that the drug is suitable for its intended purpose and that the quality of the product is assured.
Some months ago, the National Health Fund (NHF) arm of the ministry imported a quantity of Ivermectin from a supplier in the United States and, in doing so, presumably succeeded in providing the necessary information to allow for its approval. However, following on the minister’s assurances, efforts by a private company to import the very same product, from the very same supplier, were denied by the Standards and Regulations Department. Instead, a long list of requirements were provided. Assuming that the NHF provided adequate data, why the insistence on further information? It should be noted that the product from this supplier has FDA and WHO approval.
4. Reference to Merck – Merck Pharmaceuticals, the original manufacturer of Ivermectin, no longer has a patent on production. They can no longer compete with low- cost manufacturers and have no financial interest in the drug. Instead, Merck has committed millions of dollars towards the development of another drug, Molnupiravir, which it hopes to market as a treatment for COVID-19. Early in the pandemic, Japan requested Merck to conduct clinical trials with Ivermectin and they declined.
In further discussion in Parliament, the minister said “his side” of the House was unwilling to take the risk of endorsing Ivermectin for the treatment of COVID-19. This risk, as far as safety of the drug is concerned, is, according to the data, minimal. However, the risk involved in failing to use or facilitate the use of a possible effective treatment is being implicitly accepted by the Government. This should be recognised and remembered.
DR CHARLES ROYES