The amount of ivermectin needed to kill Covid-19 is toxic to humans, says Prof Salim Abdool Karim

The evidence on ivermectin is flimsy and there is no compelling case for it to be used in the fight against Covid-19.

This is according to the co-chairperson of the ministerial advisory committee (MAC) Prof Salim Abdool Karim, who was speaking on Jacaranda FM on Wednesday.

Abdool Karim said research on whether ivermectin can cure Covid-19 was currently flawed due to the small sample size and a lack of clear recommended dosages.

Ivermectin is an anti-parasitic medicine that is being studied across the globe as a possible agent against Covid-19, and in SA is currently registered for veterinary use only, with a few exceptions of external use on humans.

Abdool Karim said there was no compelling case for ivermectin to be used as a Covid-19 treatment.

“The studies are of really poor quality. When you look at the scientific evidence, there’s no compelling case for this. The doctor, Dr Andrew Hill, who did the overall analysis also said the evidence isn’t sufficiently robust to recommend its use,” he said.

“It must be clearly stated that ivermectin does not kill the virus at dosages humans can tolerate. The amount of drug needed to kill the virus is toxic to humans. Whatever it is doing, is not killing the virus.”

Abdool Karim said he is not sure why ivermectin was chosen and warned that it is irresponsible to tell people to take the drug.

Late last year, the SA Health Products Regulatory Authority (Sahpra)  prohibited the drug for human consumption after it was promoted on several social media platforms as having “cured” people of Covid-19.

The country’s top vaccinologists, scientists and infectious diseases experts also warned against the “irresponsible social media hype around the use of ivermectin” to treat Covid-19 until it was officially approved for use in humans in the country.

Speaking on a webinar hosted by Project ECHO and the National Health Laboratory Service, Prof Ian Sanne, the director of Right to Care, said, “I don't understand how ivermectin would work because it would require doses a hundredfold the dose in the studies. Also, where does it fit in the cascade of treatment?” 

However, on Wednesday, Sahpra announced that it had authorised a limited “compassionate and controlled access programme” for ivermectin to be used to treat Covid-19.

The decision came after many doctors called for it, but Sahpra said better data was needed to establish safety, doses and efficacy.

The authority said it will unveil the access protocols for the drug in the coming days.

“This does not mean that our position changes around the lack of availability of scientific data, but we had to as a regulator have very in-depth discussions around the context which we find ourselves in with the pandemic, with limited options,” said Sahpra's CEO Dr Boitumelo Semete-Makokotlela.

Prof Helen Rees, chairperson of Sahpra, said there was not yet sufficient data to indicate a full authorisation of the drug for human use, but that the programme put in place would “give respite while we wait for better data to normalise the situation”. 

“We are acutely aware that we don’t have many options for acute treatment, and we are very sensitive to what is at stake,” said Rees.