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A black market has developed in Ivermectin where many South Africans are opting for veterinary versions to stave off and stop the development of Covid-19. Professor Colleen Aldous, a health scientist at the University of KwaZulu-Natal Medical School, says there is compelling evidence that ivermectin shows promise in curing people infected with the coronavirus. Instead of obsessing over human attempts to test Covid-19, scientists must look to other ways to evaluate drugs for use in emergency conditions. She criticizes some of the biggest names in the SA scientific community for having their indicators on. She spoke to BizNews about how she went from being an ivermectin skeptic to a high school student. The regulator in SA has approved the restricted use of ivermectin, but some doctors have complained that their requests for compassionate use of the drug have not been approved. The South African health products regulator is reported to be telling Parliament that there is insufficient evidence of the drug’s use – its safety and effectiveness – to treat or prevent Covid-19. – Jackie Cameron
Professor Colleen Aldous on Ivermectin:
Ivermectin got on my radar [when] A friend of mine who was a farmer sent me a WhatsApp with the details of the experiment they did at Monash University last year – where they showed that ivermectin could kill the virus in a petri dish. That was around October. I did a quick literature search and found the first paper that appeared that ivermectin was not effective. So I just sent that back to him. At the beginning of the pandemic, a lot of straw was held on.
In December, another friend of mine actually got sick with Covid. He called me and told me his doctor wanted to take him to the hospital – he was so sick. A friend had given him ivermectin pills and he took them. Within 24 hours, he felt completely different. He was fine. When my scientist thought, I thought, ‘This is wonderful for you – great coincidence. You’d probably get better anyway. I left it at that.
Then I saw this presentation that Pierre Kory had given, and it was at that point that I realized that there was enough evidence that ivermectin had an effect [and] that scientists cannot ignore it and we cannot refuse it.
About the effect of ivermectin on Covid-19:
We don’t have a vaccine that is 100% effective on the horizon. Before we get herd immunity, we need at least a year for a vaccination program. The vaccination program will not only benefit public health by vaccinating health care workers. We must vaccinate a large portion of the entire population before we can get herd immunity.
In the meantime, we will have a third wave of this disease. We assume that it will be roughly from April / May to June – and we will bring further variants through. So everything becomes more complex. But we have a drug here that is available. Its cheap. It can be made in South Africa using compounding pharmacies.
It is no longer patented. It could have a huge impact early on in the disease by preventing a level of communicability and preventing people from getting sick.
Among the possible risks of ivermectin:
There are risks in the black market. Other people have done some tests on some of the black market drugs. Some of them have no ivermectin at all. So there are people who pay hundreds of rand for a capsule or two and get nothing. Tests have also been done to look at some of these drugs that have been contaminated with other drugs.
So there are tablets on the black market that are not necessarily that good for you. The animal preparations are not made for humans. Dosages and human response are unknown. But I know that the farmers used the veterinary preparations on their workers too. There is definitely something in there, but I’m not going to say veterinary supplements are good for humans – but people have been driven out of desperation to use them. You need to be very careful as some of the excipients in these supplements can be harmful.
About ivermectin in South Africa:
SAHPRA gave controlled access to ivermectin. At the beginning of February they announced that they would allow applications under Section 21. In their guidelines, they said they would give a 24 hour response. Unfortunately, this did not happen. If they keep their word and give Section 21 applications a 24-hour turnaround time, we’re fine in South Africa for now, as SAHPRA is a regulator.
If they have rules and regulations, they must adhere to them. If you insist on large randomized controlled trials, you will wait a very long time. Just to put in context why they’ll wait a very long time is that no one in the last year thought of doing randomized controlled trials for any of these drugs. They just went into their wards and looked at what drugs were working.
When they found a drug that worked, they did a descriptive study and published it. That’s why we have high-level scientists who say that there isn’t enough evidence – there is a lot of evidence out there. It’s just that there is academic snobbery at the level of the evidence and where the evidence is coming from. The papers are all from countries that had access to ivermectin because of parasitic diseases.
We could never have tried it in South Africa because ivermectin is not legal for human use here. But it was used in Bangladesh, Egypt, Nigeria, and South America. The trials come from there. Many people turn up their noses at this research. This research gives us some evidence on which to build evidence-based medicine. But the rules are such that some people want big, random checks and just have to wait for them.
I believe the Bill and Melinda Gates Foundation is starting a large, randomized, controlled trial on three continents and hopefully will get some results in a few months. In the meantime, we only have to come to terms with applications under Section 21 in South Africa. This goes beyond the South African borders. There are other countries that do not have access to ivermectin. This particular drug could turn the tide for this pandemic worldwide.
On skepticism about ivermectin:
There are many scientists who, as I could say, are being brainwashed to believe that the only evidence for medicine is a randomized control study, or they think it must be skeptical about everything because this is their position. But there are so many other designs that are providing research for medicine. I firmly believe that people – especially senior scientists – should open their minds and use some wisdom to examine what research has already been done.
I think we need more research. There is no formal dosage for Covid. We need dose-response studies. We definitely need PKPD studies. However, we no longer need larger, randomized, controlled placebo studies to show safety or effectiveness. That’s a waste of time [and] a waste of resources. We need to spend our energies studying how this drug can be included in a treatment regimen for Covid-19.
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