I have nothing against ordinary citizens who believe that the anti-parasitic drug ivermectin can prevent infection by the SARS-CoV-2 virus or, once they are infected, can cure them of the COVID-19 disease. The administration has so badly mismanaged the worst health emergency in the country’s history that ivermectin presents, for some reasonable individuals, a reasonable alternative with a reasonable risk factor. But the current reality is: The medical, scientific, and pharmaceutical consensus is overwhelming. Ivermectin is not recommended as preventive medicine for the virus or as treatment for the disease. The World Health Organization has advised that evidence from a total of 16 controlled trials is “inconclusive,” and that, “until more data is available,” the drug should not be used outside of clinical trials. The country’s Food and Drug Administration (FDA) has warned the public “against the purchase and use of Ivermectin veterinary products against COVID-19” and that “Ivermectin is not approved by the FDA for treatment of any viral infection.” It added that “the registered Ivermectin products in the country for human use are [only] in topical formulations under prescription use only. This is used for the treatment of external parasites such as head lice and skin conditions such as rosacea.”
Contrary to the overhyped idea that a debate among medical practitioners is “raging” in the country, only a handful of medical doctors have come out openly in favor of the use of ivermectin for COVID-19 cases. The consensus among medical societies is that there isn’t enough scientific evidence to recommend its use in the pandemic. And the Philippine Medical Association reminded its members that prescribing unregistered medicines to patients, which runs counter to the paramount principle of doing no harm, constitutes “an unethical act.”
The most important argument against its use, in my layman’s view, is that its manufacturer, Merck, has strongly rejected its use in COVID-19 cases. A statement from the company categorically stated that there “is no scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies; no meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease; and a concerning lack of safety data in the majority of studies.” In the worst pandemic in a century, Merck stands to benefit financially if ivermectin were recommended for use in COVID-19 cases; if its patent has expired (as some of the more conspiratorially minded have alleged, although I have not been able to verify this for myself), nothing prevents other drug companies from manufacturing their own versions of ivermectin. What’s stopping them?
But as I said, I have nothing against ordinary citizens who believe in ivermectin, whether as prophylactic or as treatment. But I only have contempt for politicians in power who are promoting ivermectin, as though it were almost a magic elixir. The reason why a great many among the public have turned to the possible use of ivermectin is simple: The national government’s year-long response to the pandemic has been such a failure, has been so incredibly frustrating, that ivermectin, or any supposed wonder drug, has come to symbolize hope amid, or against, desperation.
Consider the pathetic appeal of Speaker Lord Allan Velasco: “People have become desperate for a cure. Fast-tracking clinical trials and processes to either grant Ivermectin an emergency use authority or conclusively declaring it unsafe will put the matter to rest.”
In the first place, the FDA has in fact issued an authoritative advisory against the use of ivermectin. Not safe for use in COVID-19 cases pending more evidence. That Velasco does not seem to understand it or, as is more likely, is not willing to accept any advisory unless it were favorable to his view, raises the question about bias. Why did the administration and its political allies quickly accept the FDA decision to allow emergency use authorization for the controversial Sinovac vaccine, but now cavil, or pretend to misunderstand, the categorical advisory of the FDA on ivermectin?
Secondly, and more to the point: Velasco helped pass emergency powers and supplementary budgets for President Duterte to use in the pandemic. The fact that, as he himself says, the public “has become desperate for a cure,” means that either the special powers and additional funds were not enough, or that the grantee failed to use them as planned. Or both.
The failure of the national government’s pandemic response was once again put in the spotlight, or under a microscope, when Interior Underecretary Epimaco Densing, the promoter of the unconstitutional Revolutionary Government campaign, applied his lack of knowledge of democratic governance to the crisis. He told ANC’s Christian Esguerra that the pandemic was “a problem which has no solution on hand.”
THIS is why both the public and its hapless officials have come to depend on wonder drugs, or special elixirs, or magical quarantines. The national government is too incompetent to work on all the possible solutions to the crisis, all used by other, much more successful countries: Mass testing, a national contact tracing operation, adequate isolation infrastructure, properly supported medical facilities and frontlines, a fast and effective vaccine rollout.
The sad result is an update on Thoreau: Today, the mass of men and women live lives of unquiet, ivermectin-clamoring, desperation.
On Twitter: @jnery_newsstand, email: jnery@inquirer.com.ph