Ivermectin debate rages on at UKZN
Durban - A WEBINAR hosted by the University of KwaZulu-Natal (UKZN) has given further insight into ivermectin.
The webinar was entitled What the ivermectin debate has revealed to us in a time of pandemic.
On the panel was senior lecturer in pharmaceutical sciences at UKZN Andy Gray, UKZN associate professor in dermatology Professor Anisa Mosam and public health and communication specialist Dr Warren Parker.
The panellists discussed medicines selection and regulation in SA, scientific rigour and evidence-based medicine, ivermectin use and safety in dermatology and mobilising strategic policy on face masks for Covid-19 prevention: parallels with re-purposing ivermectin.
Professor Mosam said there was a mass drug administration with 3.7 billion dosages worldwide of ivermectin over the last 30 years. Some patients had received up to 20 annual doses.
“It (ivermectin) is part of the toolbox for doctors to use in Covid-19. It’s on the World Health Organisation drug list. Safety has been established in doses of 200-2 000 microgram per kilogram,” said Mosam.
Dr Parker said people were justifiably worried about the state of the pandemic and because of that, there was an uncontrolled public use of ivermectin.
That can also be taken as a piece of evidence which meant that people did not trust the epidemic response and they felt they needed to take measures themselves.
However, the uncontrolled public use posed health risks and harm. Ivermectin was a veterinary product, there was no control over dosing, it can be unsafe if incorrect doses, incorrect products and fake products are used. As a result, there are people exploiting the situation and making money in the process.
Parker said there were a number of isms that stood in the way of ivermectin.
Exceptionalism: people set a higher bar for ivermectin than the other therapies; elitism: failing to take the underlying context into account such as dismissing research credentials; absolutism: only this idea that peer reviewed RCT is the only valid evidence; skepticism: whatever research is out there is not good enough; conservatism: lack of agility, adaptability, critical thinking in the context of a severe pandemic; and over elaboration: ivermectin was thrust into the foreground as one of the most critical areas of debate, it’s just an add-on therapeutic to Covid-19 but some people see it as a huge threat.
“A way forward for ivermectin would be to take all factors into account (urgency, uncontrolled use, new variants, 3rd wave, vaccine challenges, risks, totality of evidence).
The severe stress on healthcare workers to provide effective treatment in emergency circumstances, varied resource environments. Compassionate use means immediate use for treatment: access must be as easy as any other Covid-19 treatment.
We can continue to explore possibilities for prophylaxis and there was opportunity for operational research as part of the treatment option should be implemented to support ongoing learning,” said Parker.