Access to a Covid-19 vaccine in Africa has been slow and hence the vaccination of the continent’s vulnerable groups has been constrained despite the region also facing hurdles in responding to the increasing coronavirus cases especially in the third wave due to an overwhelmed healthcare system.
Inadequacies of the respective Africa health systems have been exacerbated by the increasing demand for effective treatment of patients exhibiting coronavirus symptoms. The disease had by April 20, 2021, infected more than 4.4 million people and killed more than 118,000 others. (1)
But even as Africa grapples with constrained healthcare system under the burden of Covid-19 and delayed access to coronavirus jab, South Africa has taken the lead on the controversial use of ivermectin, distributed under the brand name Mectizan, in the treatment of Covid-19. The drug, which is manufactured by US-based Merck & Co Inc, is mainly for treatment lymphatic filariasis and onchocerciasis or river blindness, two parasites that threaten more than I billion people especially in developing countries.
Although the World Health Organization (WHO), which partnered with Merck & Co Inc in 1987 to distribute for free the ivermectin or Mectizan, and other medical regulatory authorities have warned against use of the drug in treatment of Covid-19, South Africa’s High Court sitting in Pretoria has directed that the drug be made available for patients in accordance with the country’s Medicine Act. (2)
The South Africa Health Products Regulatory Authority (SAHPRA) says there is no data yet to support the use of ivermectin in the Covid-19 treatment. The Authority had in January 2021 launched the Ivermectin Controlled Compassionate Programme (ICCP). Under the programme, SAHPRA has allowed registered medical practitioners “to apply for approval of access to unregistered ivermectin for the management of COVID-19 in individual, named patients.” (2)
But a group of petitioners that included a consortium of pharmacies, Dr George Coetzee, Afriforum, ACDP & Doctor for Life, had filed four cases against SAHPRA and the Ministry of Health, seeking more access to ivermectin for use in Covid-19 treatment. (2)
The High Court directed licensed medical practitioners to use their professional discretion to prescribe Ivermectin for the treatment of Covid-19. The drug can be compounded into a medicine with Ivermectin as an active ingredient. The compounding of the medicine should be done by a person or entity approved by SAHPRA.
In addition, those unregistered Ivermectin-containing finished pharmaceutical products for human use in the South African market should remain “accessible only under the ICCP through the authorized suppliers of such products.” (2)
Elsewhere, FengChen Group Co Ltd, a professional China ivermectin raw material supplier and manufacturer, says ivermectin is mainly used to manufacture the formulations which will help to fight against worms. (3)
Additionally, Fengchen Group Co Ltd, which has been supplying and exporting ivermectin API from China for nearly a decade, ivermectin is mostly taken orally and is “effective against worm infestations like strongyloidiasis, ascariasis.” (3)
Every year, China export about 100Mts Ivermectin raw material to the world market with Fengchen Group saying it holds 10% of this global market.
Approved for Treatment
Meanwhile, the European Medical Association (EMA) says ivermectin is not authorized for use in COVID-19 treatment within the EU although two of its members-Czechia and Slovakia- have approved it for temporal use in treatment of coronavirus. (4)
Furthermore, WHO says the evidence available as of March 2021, when it gave an update on the push to have it approved for use in treatment of Covid-19 “is inconclusive.” (5)
“Until more data is available, WHO recommends that the drug only be used within clinical trials,” the UN health agency says. (5)
The WHO precaution has also been echoed by the Africa CDC that says the use of ivermectin is not based on any scientific evidence from pre-clinical studies on the therapeutic effect of the drug for the management of COVID-19.
Currently, Africa CDC says there is “no evidence of its clinical efficacy for the management of patients with asymptomatic, mild, moderate or severe COVID-19 and also no safety data regarding the use of ivermectin for COVID-19 in the majority of the published studies.” (6)
Other African countries such as Algeria and Zimbabwe have each warned against use ivermectin to treat COVID-19.
Algerian health authorities say ivermectin is being circulated in the black market thus endangering the health of consumers.
Meanwhile, Zimbabwe’s Ministry of Health and Child Care also says “there is no specific medicine to prevent or treat coronavirus disease.” (7)
The increasing pressure on African governments and medical authorities to effectively tackle the increasing burden of Covid-19 calls for intensified scientific research and trials on the effectiveness ivermectin and other available drugs in treatment of the coronavirus disease.