As Azuka lay 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.

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.

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.

“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”.

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.

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.

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.

“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.

The World Health Organisation (WHO) has warned that Africa is in danger of being left behind in Covid-19 vaccination as countries from other regions strike bilateral deals, thereby driving up prices.

This follows the development and approval of safe and effective vaccine less than a year after the emergence of the coronavirus pandemic, regarded as a stunning achievement.

This disclosure was made by the WHO’s Regional Director for Africa, Dr Matshidiso Moeti while speaking during a virtual press conference which was facilitated by APO Group.

Dr Moeti was joined at the press briefing by the Managing Director, Country Programmes, Gavi, Thabani Maphosa and UNICEF Regional Director for Eastern and Southern Africa, Mohamed Fall.

What the WHO’s Regional Director for Africa is saying

Dr Moeti stated that as of early this week, 40 million Covid-19 vaccine doses have been administered in 50 mostly high-income countries with Guinea being the only low-income country on the continent to have provided doses to only 25 people so far.

According to her, Seychelles is the only high-income country on the continent where a national Covid-19 vaccination campaign has started.

She said, “We first, not me first, is the only way to end the pandemic. Vaccine hoarding will only prolong the ordeal and delay Africa’s recovery. It is deeply unjust that the most vulnerable Africans are forced to wait for vaccines while lower-risk groups in rich countries are made safe.

“Health workers and vulnerable people in Africa need urgent access to safe and effective COVID-19 vaccines.’’

What the Managing Director, Country Programmes, GAVI, is saying

Mr Thabani Maphosa, the Managing Director, Country Programmes at GAVI, a partner in the alliance, was quoted as saying delivery would begin soon.

He said, “COVAX is on track to start delivering vaccine doses and begin ensuring global access to vaccines. This massive international undertaking has been made possible thanks to donations work towards dose-sharing deals and deals with manufacturers that have brought us to almost 2 billion doses secured. We look forward to rollout in the coming weeks.”

What you should know

• COVAX facility is an international alliance which is backed by the WHO, Gavi, the vaccine alliance and Coalition for Epidemic Preparedness Innovations (CEPI), to ensure equitable distribution of the Covid-19 vaccines among all countries regardless of income level.
• The alliance has secured 2 billion doses of the Covid-19 vaccine for Africa from 5 producers, with options of over 1 billion more doses.
• COVAX has committed to vaccinating no fewer than 20% of the population in Africa by the end of 2021.
• Priority will be given to health workers and other vulnerable groups, such as older persons and those with pre-existing health conditions.
• An initial 30 million vaccine doses are expected to begin arriving in countries by March.
• The United Nations in its report said that a maximum of 600 million doses will be disbursed, based on 2 doses per person.

Recent research findings suggest that the new coronavirus variants would likely pose a big challenge for the vaccines, as revealed by studies by several medical researchers.

The new variant was first discovered in South Africa in October but has now been spread to more than a dozen countries all over the world.

According to the most recent findings, as reported by CNN, researchers took antibodies from six people who were hospitalized with Covid-19 before the new variant was discovered. They found to varying degrees, that the antibodies for all six of the survivors were unable to fully fight off the virus.

According to Alex Sigal, a virologist at the Africa Health Research Institute and the Max Planck Institute for Infection Biology, “I think the evidence is building that these mutations — and I think other mutations — will emerge across the globe — and are emerging already — that are escaping antibodies from previous infection. It’s concerning.”

According to Jesse Bloom, a virologist at the Fred Hutchinson Cancer Research Center, “When you see two groups independently arriving at same basic answer, that good — there’s more consonance that they are correct”

What you should know

• Sigal’s findings were very similar to those of a recent study by the National Institute for Communicable Diseases in South Africa.
• A research study has revealed that mutations in the new variant allowed them to evade some of the immunity induced by vaccination, but it was far from a complete escape.
• One thing that is critically safe for everyone is to get vaccinated, while the researchers are working to confirm whether these variants are dangerous or not to contain with the vaccines.
• According to Alex Sigal, “I would for sure get it if I could. My father-in-law had the opportunity to fly to Israel and get it, and I was shooing him out of the house because you can’t get it here in South Africa.”
• In a research study done at Rockefeller University, from a sample of 20 people who had received either the Moderna or the Pfizer vaccine, it was found that different mutations in the viruses did allow some escape from some types of antibodies, but the volunteers’ immune systems threw an army of different types of antibodies at the viruses.
• According to the research conducted in South Africa, blood was drawn from 44 people who had Covid-19 but the antibodies of about half of the 44 people were powerless against the new variant, while the other half, their antibody responses were weakened, but not totally knocked out.