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Covid-19: Ivermectin’s politicisation is a warning sign for doctors

BMJ 2021; 373 doi: (Published 01 April 2021) Cite this as: BMJ 2021;373:n747

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Re: Covid-19: Ivermectin’s politicisation is a warning sign for doctors turning to orphan treatments

Dear Editor

Zoonotic diseases are on the rise due to exponential rise in the global population causing man to encroach on new ecological habitats in search of space, food, and resources as well as improved opportunities for rampant wildlife trade causing inter-species virus jumps. The fact that the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) virus has been thought to have originated from wildlife and may have “jumped” into humans, not only highlights future risks from animal-borne diseases but also provides an important clue to its resolution.

In unusual times likes these, when the world is battling with a virus, drug repurposing can be possible solution to avoid needless deaths. It is concerning that few drugs (Remdesivir, tocilizumab) were given emergency approval for use against COVID-19 without adequate trials on their safety profiles, Ivermectin, on the other hand has been withheld in spite of 35 years of favorable pharmacovigilance records, and many well designed Randomized controlled trials on its efficacy. [1]

Secondly, recent studies have shown Vitamin D to play a role in COVID-19 and to call it an "orphan treatment" would be incorrect. [2]

The hospitals are overwhelmed and the doctors are overworked. They depend on health authorities to carry out meta-analyses and come up with guidelines that need to be followed. In the present circumstances, what seems unusual is the focussed intentional systematic suppression, forbidding and censoring of a cheap, widely available, life-saving therapeutic, Ivermectin, in the middle of a pandemic.

There have been various groups that are creating awareness around Ivermectin for COVID-19, including the frontline covid-19 critical care alliance [3] created by highly published critical care specialists from major academic medical centers and the British Ivermectin Recommendation Development (BIRD) Panel headed by Dr Tess Lawrie. The BIRD is an evidence based consultancy collaboration of 75 researchers, specialists, patient representatives [4] that follow the W.H.O “evidence to decision framework” to conduct metanalyses and systematic reviews of Randomised Controlled Trials (RCT) of Ivermectin on COVID-19. As per this group, Ivermectin is recommended strongly for all phases of COVID-19.

A Review Article: Global trends in clinical studies of ivermectin in COVID-19 published in March 2021 in The Japanese Jpurnal of Antibiotics has been co-authored by Dr. Satoshi Ōmura. In the article they have described the benefits of ivermectin in COVID-19 as: " Ivermectin may even turn out to be comparable to the benefits achieved from the discovery of penicillin—said to be one of the greatest discoveries of the twentieth century. Here, one more use for ivermectin, which has been described as “miracle” or “wonder” drug, is being added. History has demonstrated that the existence of such natural product-derived compounds with such diverse effects is exceedingly rare. " [5]
Satoshi Ōmura is known for the discovery and development of various pharmaceuticals originally occurring in microorganisms. He was awarded the 2015 Nobel Prize in Physiology or Medicine jointly with William C. Campbell and Tu Youyou for discoveries concerning a novel therapy against infections caused by roundworm parasites. More precisely, his research group isolated a strain of Streptomyces avermitilis that produce the anti-parasitical compound avermectin. This lead to the discovery of ivermectin. [6]

In the end, we need to also realise that Ivermectin is not a replacement to social distancing, masks and personal protection equipment. To achieve post-pandemic phase globally, large scale vaccination programmes have already begun in full swing all over the world. The vaccines are developed keeping the S proteins in mind, i.e they are virus-directed, and some "vaccine escape strains " have been a cause of worry. [7] Ivermectin, on the other hand, targets the virus as well as the host and could work on these strains as well. [8]

While several countries and some sections of the population need to wait for their turn to get vaccinated, Ivermectin could act as a safety bridge, in saving human lives, while we get there.

2. Cutolo M, Paolino S, Smith VEvidences for a protective role of vitamin D in COVID-19RMD Open 2020;6:e001454. doi: 10.1136/rmdopen-2020-001454
6. "Satoshi Omura PhD". Retrieved 5 October 2015.
7. Garcia-Beltran et al., Multiple SARS-CoV-2 variants escape neutralization by vaccine-induced humoral immunity, Cell (2021),
8. Abhigyan Choudhury, Nabarun C Das, Ritwik Patra, Manojit Bhattacharya, Pratik Ghosh, Bidhan C Patra, and Suprabhat Mukherjee. Exploring the binding efficacy of ivermectin against the key proteins of SARS-CoV-2 pathogenesis: an in silico approach. Future Virology 0 0:0

Competing interests: No competing interests

16 April 2021
Otolaryngologist and Researcher
Dr. SUNNY DAWOODI, Mumbai, India
MGMMC INDIA, Association Naso Sano, Italy