The European Union (EU) has said that it will make pharmaceutical companies respect contracts they have signed for the supply of Covid-19 vaccines.

The statement by the EU follows a series of delays and slowdowns in the supply of the vaccines from some drugmakers.

According to a report from Reuters, this disclosure was made by the European Council President, Charles Michel, while speaking to Europe 1 radio on Sunday, January 24, 2021.

Michel in his statement said, “We plan to make the pharmaceutical companies respect the contracts they have signed … by using the legal means at our disposal.’’

While he made no mention of possible sanctions, Michel said that the EU would insist on transparency about the reasons for the delays.

He pointed out that after Pfizer’s first warnings about delays of several weeks, the EU had managed to reduce these delays by taking a tough stance.

Michel also said, “We banged our fist on the table and finally announced delays of several weeks turned into a slowdown of deliveries.’’

What you should know

• It can be recalled that Pfizer Inc last week announced that it was temporarily slowing supplies to Europe to make manufacturing changes that would boost output.
• On Friday, AstraZeneca also said that initial deliveries to the region will fall short because of a production glitch.
• Pfizer had been set to deliver about 80 million doses of the Covid-19 to the 27 countries by March.

The FG has stated that it will buy Oxford/AstraZeneca Covid-19 vaccine for Nigerians, given the availability of facilities needed for its storage.

This is according to the Executive Director/Chief Executive Officer of the National Primary Health Care Development Agency (NPHCDA), Dr. Faisal Shuaib, as reported by The Nation.

Speaking during a television interview, Dr Shuaib asserted: “The AstraZeneca type Oxford vaccines are the ones that we want to invest in because we already have the infrastructure across the country to be able to store the vaccines.”

He noted the Oxford/AstraZeneca vaccine can be stored in a facility with temperature +2 to +8 degree Celsius for a long period without it losing potency.

The decision may mean that Pfizer/BioNTech’s vaccine will not be considered since it appears the country lacks the capacity to keep the drug at the required temperature level for a long time.

The NPHCDA added that the National Agency for Food and Drug Administration and Control (NAFDAC) would assess and certify the vaccine to ensure that it is safe.

Noting that: “For us, this is the paramount consideration and no vaccine will be administered to Nigerians until and unless NAFDAC goes through the process of making sure that all of the documentation is right and it is contextualised within the Nigerian environment.”

What they are saying

Dr Shuaib noted that:

“In Nigeria, as I speak, almost every single political ward has one freezer that can keep these vaccines at the right temperature.

“Only about 700 political wards do not have this type of equipment, and we are hopeful that if we keep installing them at the pace that we want to, hopefully by the end of this year, we will be able to finish installing, so that in every single political ward, we have the right equipment to be able to store our routine immunisation vaccines, including the COVID-19 vaccines at + 2 to +8 degree Celsius.

“At this point, we have information from the COVAX facility that Nigeria will be getting up to 100,000 doses of the Pfizer vaccines in February. But ahead of those shipments, we have already made sure that the ultra-chain equipment that is required to keep these vaccines in temperatures of -70 degrees Celsius are available in-country.

“We are also working with the sub-national levels to make sure that when these vaccines are transported to the states and council areas, we will be able to make sure that the transportation takes place in a way that ensures that the vaccines remain and retain their potency.”

What you should know

• Nairametrics reported on 2oth January that the FG favours and will acquire vaccines that need less cooling. The report had it that the FG is in talks with Russia and India to procure vaccines that are less dependent on cooling facilities.
• Oxford’s AstraZeneca vaccine is made from a weakened version of a common cold virus (known as an adenovirus) from chimpanzees. It has been modified to look more like coronavirus – although it cannot cause illness.
• When the vaccine is injected into a patient, it prompts the immune system to start making antibodies and primes it to attack any coronavirus infection.
• Unlike Pfizer’s vaccine – which has to be kept at an extremely cold temperature (-70 degree Celsius), the Oxford vaccine can be stored in a normal fridge – making it easier to distribute.
• The vaccine was approved for use by UK’s medicines regulator – the MHRA on December 30, last year. The MHRA approved the use of two full doses, which was found to be 62 per cent effective.

According to Nairametrics Covid-19 tracker, as of Saturday 24^th January 2021

• The total number of cases stood at 121,566.
• The total number of death stood at 1,497.
• The total number of tests conducted stood at 1,258,534.

As Azuka laid down in bed feverish, he had resigned to his fate believing he was not going to make it to the next day.

Just 3 days into the new year and all the fun he had, attending weddings and burial ceremonies in the east all seemed like a big mistake. He must have caught covid-19 at one of those events, he thought.

Since attending the last event, he fell sick and has been exhibiting the symptoms of Covid-19 and just waiting to die until someone recommended Ivermectin, a little known drug as a potential medicine that could help save his life.

READ: Only 68.8% of Nigerians believe Covid-19 is real – SBM Intel

A few days later he recovered and spread the news to friends and family – he believes Ivermectin cured him.

The rush to purchase Ivermectin in Lagos has increased of late after stories similar to that of Azuka (not his real name) spread. As Nigeria’s caseloads rise past 120k cases, some Nigerians are increasingly worried about contracting Covid-19, rushing to pharmacies to purchase a drug that they all believe is the most portent to fight Covid-19.

READ: Hepatitis C drugs may be effective against COVID-19, virus may spread through high-rise buildings

What is Ivermectin?

According to the World Health Organisation, Ivermectin was originally produced in the 1980s as a veterinary drug used largely for nematode control in cattle, horses, pigs, and dogs and became the standard for control of the ectoparasitic disease, scabies. It soon became the world’s most profitable veterinary drug.

Since then, Ivermectin has been used on humans for controlling strongyloidiasis, a human pathogenic parasitic roundworm causing the disease strongyloidiasis. According to medical sources, it is also known in the US as threadworm, UK, and Australia as pinworms.

In Nigeria, it has been used to treat worms, according to a pharmacist who spoke to Nairametrics.

READ: Nigeria, others to receive first-ever HIV generic drug for babies in the first half of 2021

“Originally it’s a worm expeller (Antihelminthic) used in the elimination of parasitic worms from the body. They use it in combination with doxycycline. They also use Vitamin C in combination with Axrthromycin.”

However, more recently, the drug is now being used for the treatment of Covid-19 pushing demands for the drug high across pharmacies in Lagos. A Nairametrics survey suggests the drug cost as high as N100,000.

Another pharmacist who craved anonymity explains.

“It was one of the available free drugs dispensed to patients at clinics in Nigeria – for eliminating different types of worms from the body. People usually don’t buy it from pharmacies because of the low price, thinking it’s not good quality tabled for expelling worms. It was not expensive and almost cost next to nothing, but now it sells for as high as N200 per tablet”

At N200 per tablet, a pack of 500 tablets could go for as high as N100,000. From all indications, the prices are unstable and could be purchased from as little as N20,000 per pack of 500 tablets to as high as N100,000. It all depends on demand and supply and who is under pressure to get a “cure”.

READ: COVID-19: WHO warns against Gilead’s remdesivir drug approved by US FDA

Is the drug credible?

Several social media posts and videos allude to the efficacy of the drug in “preventing and curing” Covid-19 but this is yet to be certified by the WHO.

The drug however came into the limelight after a Financial Times article claimed the drug had a chance of cutting covid-19 deaths by up to 75%.

The article was based on research published by the International Ivermectin Project Team led by the University of Liverpool lecturer Andrew Hill. A Nigerian Olufemi Emmanual Babalola, from Bingham University/Lagos University, Nigeria is also part of the group.

READ: WHO study reveals new discovery about remdesivir drug’s effect on Covid-19 patients

Here is an excerpt of the result of the research conducted by the group

“Ivermectin was associated with reduced inflammatory markers (C-Reactive Protein, d-dimer, and ferritin) and faster viral clearance by PCR. Viral clearance was treatment dose- and duration-dependent. Ivermectin showed significantly shorter duration of hospitalization compared to control. In six RCTs of moderate or severe infection, there was a 75% reduction in mortality (Relative Risk=0.25 [95%CI 0.12- 0.52]; p=0.0002); 14/650 (2.1%) deaths on ivermectin; 57/597 (9.5%) deaths in controls) with favorable clinical recovery and reduced hospitalization. “

Currently, the only other drug with the same level of worldwide unofficial approval for treatment of Covid-19 is Remdesivir, after it also showed an effect on improving recovery rate for Covid-19 patients.

READ: US Mission recognises Nigerian doctor who helped develop COVID-19 vaccine

The choice between waiting for a vaccine or self-medication

More recently, the search for cures for Covid-19 has been overshadowed by vaccine breakthroughs across the world. For most governments, preventing covid-19 is better than curing it which is why more effort is geared towards vaccine distributions and other preventive measures such as insisting on facemasks and introducing new lockdowns.

But for developing economies like Nigeria, where self-medication is prevalent, drugs like Ivermectin are easier to purchase over the counter as well as administer. Just like the demand for chloroquine, zinc, and vitamin C soared in the first wave of Covid-19, demand for Ivermectin is rising along with its price.

Fortunately, Ivermectin is backed by research even though the researchers expressed caution as more trials need to be conducted.

READ: Nigeria records 1,964 new cases of Covid-19, highest daily surge

“Despite the encouraging trend this existing data base demonstrates, it is not yet a sufficiently robust evidence base to justify the use or regulatory approval of ivermectin. However, the current paucity of high-quality evidence only highlights the clear need for additional, higher-quality and larger-scale clinical trials, warranted to investigate the use of ivermectin further.

“The maximum effective dose of ivermectin needs to be clarified and new clinical trials should use a consistent multi-day dosing regime, with at least 0.4mg/kg/day. The appropriate dose and schedule of ivermectin still requires evaluation and the current randomized clinical trials of ivermectin need to be continued until ready for rigorous review by regulatory agencies.” International Ivermectin Project Team 

Asides Ivermectin, Nigerians have also resorted to traditional medicine such as a beverage of lemongrass, dogonyaro leaves, garlic, ginger, and bitter kola to prevent and cure Covid-19, despite orthodox vaccines proven to be effective.

Perhaps it is because no one is sure when the vaccine will get to Nigeria after it was initially meant to arrive in January and since pushed to February 2021. And even if it does arrive in Nigeria, most people do not believe it will get to ordinary Nigerians on time especially when they cite the way the Covid-19 palliatives was handled.

For now, the need for self-reliance is driving people towards any drug they believe can cure covid-19.