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  • Writer's pictureProf. Colleen Aldous

Ivermektien het nog niemand doodgemaak nie

The mis-and dis information pandemic

I applaud Dr. Marthinus Viljoen for providing an extensive overview of his thoughts on the use of

Ivermectin in the treatment of COVID-19. We are lucky enough in South Africa to have a free press

where debate is possible. To this end I would like to add some facts to Dr Viljoen’s communication

that will help the public make up their own minds.

Dr Viljoen is correct when he says the COVID-19 has been shadowed by a sinister pandemic of mis

and dis information that has exacerbated the suffering of people across the globe. What he doesn’t

realise is that he could well be unwittingly participating in it along with other mainstream media,

social media and regulatory authorities. As thinking citizens who do we believe? Any thinking citizen

would know to be sceptical of social media, the mainstream media have joined forces to decide

what they think is mis or dis information and regulatory authorities have conservative agendas that

they defend in what they define as the interests of the public. It is clear, that we need to take

responsibility for ourselves, find accurate information so that we can think for ourselves and make

well informed decisions. And bear in mind that even those experts we have respected and have had

blind faith in for decades, are human and have opinions that they may pass off with authority as fact.

I agree with Dr Viljoen, truth can make one uncomfortable, and I would like to add some

uncomfortable truths to his communication.

When one talks of a drug being popular, the implication is that it is based purely in anecdotal tittle-

tattle. Let’s ask why Ivermectin has remained popular for approaching a year now. Why it did not

disappear from conversation after SAHPRA’s letter in December which warned that Ivermectin could

be lethal? Could it be that doctors are successfully treating COVID-19 with regimens which include Ivermectin? Or that patients who have been treated with it, when no other option was offered to them, got better and now they want the same for their families and friends? Those in authority will say Ivermectin is being kept alive by anecdotes and emotion. Anecdotal evidence is the spoken truth of those with experience and forms the lowest reliable medical information. But when hundreds of doctors and patients have the same anecdotes to share, the evidence cannot be ignored. And yes, I guess emotion has something to do with it, especially when the stakes are as high as a person’s life.

However, there is much more than anecdotal evidence for the efficacy and safety of Ivermectin in

treating COVID-19. In early drug repurposing experiments, Caly et al found that Ivermectin was a

good potential drug to follow up with further research. After they published their laboratory-based

experiment where they showed that Ivermectin killed the SARS-COV-2 virus in a petri dish, doctors

at the coalface of COVID-19 treatment, who had experience in using Ivermectin as an antiparasitic

drug, started using it with varying levels of success. Ivermectin is registered for use in countries

where parasitic disease is endemic, so it stands to reason that the first research would come from

countries like Egypt, India and South American countries etc. These were studies carried out without

major funding, by the clinicians in the front line and are not the large big-pharma financed studies

carried out for novel drugs in the West. To call these studies poor quality is nothing short of

academic snobbery, especially when at least 36 of them have been published in peer-reviewed


Current research into Ivermectin on COVID-19 treatment

On 31 August, I carried out a comprehensive search of PubMed, Ebsco Host, Web of Science and

Scholar.Google with the search string (SARS-COV-2 OR Coronavirus OR COVID-19) AND (Ivermectin)

to find published research to provide a more accurate picture of the state of research on Ivermectin

in COVID-19 treatment. I deliberately excluded pre-print research because of the recent debacle

with the Elgazzar study. The search rendered 36 human trials. Five of these did not reach statistical

significance. These included the often quoted Villejos and Lopez-Medina studies which, if the

readers read the entire studies, state in the limitations of their studies, had protocol design factors

that may have influenced the poor outcomes for Ivermectin and both suggested further research

which would address these confounders. The other 31 studies, which included pilot studies, case

studies, case series, retrospective and prospective cohort studies as well as randomised control

trials, all showed positive outcomes. There is not a single study out of these 36 that has stated that

the pursuit of Ivermectin as a treatment in COVID-19 is futile or that it causes any harm. And I

certainly have not found the research Dr Viljoen refers to that says Ivermectin renders the COVID-19

patient worse off.

The large double-blind randomised control trial that is a requirement for authorities to make up

their minds about Ivermectin one way or the other, is and will remain elusive. Merck carried out all

the trials on the safety of Ivermectin in the last century and early in this century. Dr Viljoen provides

an excellent background to the discovery of Ivermectin and to Merck’s noble Mectizan program

which improved the quality of life of so many peoples across the globe and which ultimately led to

the discoverer and developer receiving the Nobel Prize for medicine six years ago. Merck has lost the

patent to Ivermectin now and are developing a new antiviral, molnupiravir, which they hope to

launch soon for emergency use.

Merck was also the company that created the drug Vioxx, a nonsteroidal anti-inflammatory. They

were aware of Vioxx’s cardiovascular risks early on, which resulted in up to 139 000 heart attacks

and strokes, 30-40% of them likely fatal. Not only did Merck hide the scale of this problem, they also

condemned those who cautioned on these serious adverse events. According to Moynihan in his

article on this scandal in the BMJ in 2009, one Merck executive emailed another: “We may need to

seek them out and destroy them where they live.” Merck provided a $410 million budget

disinformation campaign to keep Vioxx in the market. It was eventually withdrawn in 2004.

A company is as no