EDITORIAL - Ivermectin: Boon or bane?

At the end of March, the World Health Organization released its statement on the anti-parasitic drug ivermectin. The drug has become controversial as doctors in several countries including the Philippines began prescribing it as supplemental treatment for COVID-19. While there is still no cure for COVID, doctors are prescribing medicines to cure its symptoms and prevent infections from becoming serious or causing death.

Dr. Allan Landrito has been so convinced about the efficacy of the medicine against COVID that he says he imported pure Ivermectin, compounded it himself into pills “with an inert ingredient” and sold thousands of bottles around the country.

Landrito, who has resigned from the health department of Muntinlupa, explained that he was forced to compound his own pills because the only Ivermectin formulations available in the Philippines are only for animal use as well as a topical cream for treating head lice and skin discoloration.

Several other doctors stress that Ivermectin had worked for their COVID patients. With the current COVID surge, the scarcity of vaccines and the urgency of the situation, they say they are prepared to do whatever it takes to save more lives and prevent serious infection. They also cite the immense affordability of the drug compared to approved treatments such as Remdesivir, and stress that people must be given the choice of alternative treatments for COVID.

Other doctors, on the other hand, point out that the efficacy of Ivermectin against COVID is inconclusive – which is what the WHO declared in its March 31 advisory on the drug. Instead the WHO said the drug can be used within clinical trials as COVID treatment. The WHO statement is based on pooled data from 16 randomized controlled trials involving 2,407 people with COVID including both outpatients and inpatients. The study did not look into the usefulness of Ivermectin for preventing COVID.

Dr. Benigno Agbayani, president of the Concerned Doctors and Citizens of the Philippines, says the formulary of Ivermectin was in fact designed for humans. He says Ivermectin is now being used to treat COVID in countries including India, Japan, Peru, Portugal, Slovenia and Zimbabwe. The Employers’ Confederation of the Philippines is also supporting the use of the drug against COVID.

The WHO must quickly resolve this controversy, and the Philippine government must speed up assessment and processing of any application for the importation or manufacture of the human formulation for Ivermectin. A Chinese traditional herbal drug is already widely used as supplemental treatment for COVID. If there are other alternative treatments being pushed by doctors themselves, they deserve consideration. In battling a deadly disease with no known cure, every weapon must be wielded.