Politics, Profits and People: Regressive Priorities Over COVID-19 By Olukayode Oyeleye
There are arguments making rounds about whether or not a drug with the generic name IVERMECTIN has any bearing, usefulness or therapeutic effect on Coronavirus (COVID-19) infections. Opinions may vary on this subject, but the facts remain unchanged by sentiments and innuendoes that underlie the arguments. This case has highlighted one thing: the global health body is viewing the control of COVID-19 crisis through narrow prism. It is time to face realities. There is a scientific validity to the claim about IVERMECTIN for COVID-19 therapy, which means it is appropriate for use.
LANCET is one of the globally respected scientific and medical journal publications. Here’s a quote from its report on a research on IVERMECTIN in COVID 19 therapy. “Among patients with non-severe COVID-19 and no risk factors for severe disease receiving a single 400 mcg/kg dose of ivermectin within 72 h of fever or cough onset there was no difference in the proportion of PCR positives. There was however a marked reduction of self-reported anosmia/hyposmia, a reduction of cough and a tendency to lower viral loads and lower IgG titers which warrants assessment in larger trials.”
It is important to pay attention to the expression “lower viral load,” which means the multiplication of the viruses is arrested. In layman’s terms, it slows down or prevents the multiplication of the viruses. This happens at the cellular level. And in cases of infections generally, any slowdown of any infective agent provides an opportunity for the host body’s cells to rapidly build antibodies against the “intruders.” In the triangle of infections, once the host and environment are able to tilt the balance against the infection, the infection is subdued and the host prevails. That is what is referred to as recovery. Notice also the emphasis on “no risk factors,” which means no underlying conditions that are favourable for spread of infections, as in cases of immunosuppression, TB, HIV/AIDS, diabetes, poor nutrition or old age. Any other stressor to the body could also pose as a risk factor.
So, Lancet’s results have proven Ivermectin as useful. But in medical journal reports, ethics require that authors of research reports don’t give definite declarative statements suggestive of final opinion or definitive end, but rather provide indications as signposted at the end of the Lancet quote, thus: “which warrants assessment in larger trials.” In other words, other research scientists can prove further our findings by setting up their own independent studies, and subsequent decisions or actions could be based on the judgments of those who may want to follow the logic to embark on definite actions. This enriches the earlier claim and strengthens the validity of claims that may be made subsequently.
I knew IVERMECTIN way back since around 1990. It was sold under the trade name IVOMEC back then and was available in different formulations for animals as well as humans for getting rid of endoparasites and ectoparasites. I used it during my period of practice on the field as veterinarian, before I joined the media. I am also aware of its diverse applications to many unrelated conditions. A good knowledge of pharmacology helps any doctor, whether veterinary or hominine, to make well informed decisions in disease therapy. Some drugs originally made for one ailment have been found to be effective and efficacious against some other unrelated ailments. Many therapies were discovered by chance, accident or observation. The drug makers may initially insist they did not make a drug for one particular purpose. But after a period of review of feedback from the field, they are most likely to be inclined to accepting the realities they find later. The widening frontiers of scientific knowledge have led to the production of breakthrough drugs that were not imaginable half a century ago.
Medical literature is replete with updates, reviews, retractions and additions, depending on what is applicable from field experiences and because the frontiers of knowledge keep widening from time to time. That explains why some drugs are recalled when some undesirable effects (not necessarily just side effects) are clearly documented. That is also why some drugs are modified over time. River Blindness (onchocerciasis) control programme was implemented in Africa in the early 1990s. In that programme, AFRICARE became popular for its role, which tremendously helped many in the rural north of Nigeria. An open access report published by Springer Nature, with the title “Health Research Policy and Systems,” disclosed that, “after 15 to 17 years of ivermectin treatment in two onchocerciasis foci in Kaduna State, Nigeria, prevalence had fallen to zero level in all communities and all individuals examined were skin-snip negative.” That was from a tracked intervention.
It is highly possible that the producers of ivermectin had only scratched the surface when they restricted its use to parasitic infestations. The drug has been in the market for more than a quarter of a century. That is remarkable. Many drugs don’t last this long in the market. Either they are already withdrawn or had been significantly modified. Since the time of emergence of ivermectin, the world has witnessed three generations of antibiotics for veterinary and human use. Laboratory scientists would readily attest to the trouble they began to have with some drugs after repeated and prolonged experimental uses. Those in that generation when ivermectin first emerged on a global scale are no more allowed to be used for therapies nowadays. It means there is something peculiar and interesting about ivermectin.
Now, to the application in COVID 19 control, it appears that the big pharmaceutical companies, particularly those that stand to gain more from vaccines are not favourably disposed to any other remedy. For them, it does not appear that the cost-benefit analyses from the perspectives of end users are of any relevance. The power of big companies to lobby those in government and influence policy direction is not in doubt. Big pharma as monopolies, either singly or as a collective, have influenced major policy decisions about what is offered to the unquestioning public. Meanwhile, vaccines and monoclonal antibodies are supposed to be preventive, not remedial. Their apparent fixation on these restricted options are not done out of pure altruism. The vaccine producers will want to recoup their expenses, break even and make profits in addition to the heroism they will generate.
Relative absence of media practitioners with sound medical science background allows the knowledge vacuum to remain expanded. Vaccines and monoclonal antibodies have some similar constraints. Vaccines have one peculiar problem which the producers don’t seem keen to let people recognise, let alone focus upon. In cases of viral mutations, the vaccines produced against any particular strain of virus will not be effective against other strains. The same goes for the monoclonal antibodies. Such an approach is even more like gambling in a population without testing done. The basis for vaccination in an epidemic is usually weak; sometimes it is based on expediency. Chances are high that the use of such vaccines or antibodies is going to be more of ‘hit or miss’ efforts.
Vaccine producers aren’t likely to be sincere enough to educate users adequately on this. It is not necessarily nearly akin to the advert caveat that “tobacco smoking is dangerous to your health,” where – at least – they are forced by regulatory agencies to make disclaimers while still promoting the product. To counter their disclaimers, they still promote the same consumer goods, using celebrities, posing with state-of-the-art cars or posh apartments. This is in an attempt to distract the mind away from the real existential dangers associated with smoking. New strains of COVID-19 are already reported in Chile, Denmark, the UK and US. These should be troubling enough for those promoting vaccines that have been made without these variants in mind as it should also be for those prospective vaccine users, particularly as the vaccines may not confer the expected immunity on new strains if or when they strike. So, none of the currently touted COVID-19 vaccines is a silver bullet against the infection.
Authoritative reports showed that Trump administration’s ‘Operation Warp Speed’ has spent $12.4 billion on vaccines in the US. Within this arrangement, it reportedly made an agreement, in mid-July, with Pfizer, one of several pharmaceutical companies working to develop a COVID-19 vaccine. The TIME magazine specifically wrote about the Pfizer deal that “the $1.95 billion deal would finance the production and nationwide delivery of 100 million doses of the vaccine, should it be approved by the U.S. Food and Drug Administration.” Pfizer in US co-developed its vaccine with BioNTech in Germany. Moderna, another US pharma company, had a deal with the Trump administration to produce COVID-19 vaccines. On August 11, the U.S. Department of Health and Human Services (HHS) and Department of Defense (DoD) announced “an agreement with Moderna, Inc. to manufacture and deliver 100 million doses of the company’s COVID-19 vaccine candidate.” These are part of the big spending reported, in which case government bought the vaccines ultimately.
What makes the vaccine story scary is the big and aggressive push for vaccines without allowing discussions about alternatives. There are reasons to suspect a high level of conspiracy and secrecy, especially as it is emerging that the virus must have been deliberately spawned and allowed to spread. Earlier observations at the onset of the pandemic and – very recently – the initial refusal of China to allow experts from WHO to have access to China, and a subsequent volte-face, provided a good basis for suspicion that China has something to hide. Some promoters are, it appears, trying to use people as Guinea Pigs in a global-scale laboratory. They are probably trying to use the measures to achieve some form of control and intrusion into people’s privacy, by using the vaccination certificates to determine people’s international movement as some are already talking about vaccine passports. In China, surveillance system has been expanded to include information about COVID-19 vaccination status of individuals. The draconian lockdowns are also questionable as they affect various people’s health negatively to various extents. Unfortunately, those who are promoting these ideas are not medical people but business magnates, politicians and high ranking government officials, those with some forms of world vision, who have some other ways of influencing people’s lives on a large scale. There is something suspicious over the relentless push for only vaccines, even when the price per dose is higher compared with some notable therapeutic products per capita. The interface of economics, governance and medical knowledge still appears poor in COVID-19 control. Sadly and disappointingly, the global mainstream media gleefully sing and repeat the populist refrain without questioning.
People should not be deluded into believing that these big pharmaceutical companies cannot knowingly do any wrong. They are in business to make money. Any claim that they are out to save lives is just a superficial and incidental explanation. Ultimately, their bottom line decision is influenced by profit motive; every other publicly stated motive is subordinate. The big pharma industry in the US was responsible for the opioid addiction epidemics that have rocked the country in the past couple of years. Johnson and Johnson was ordered to pay $572 million in a landmark judgment against it in August 2019. Towards the end of 2020, Purdue Phama, was ordered to pay $5.5 billion in penalties, of which $3.54 billion was criminal fine. Their offence was their complicity in promoting opioid addiction, which they did by rewarding doctors for deceiving patients and prescribing the opioids even when not medically relevant or necessary. So, if doctors that were supposed to save lives fell for the pecuniary carrot from Johnson & Johnson and Purdue Pharma, how is the carrot of Pfizer/BioNTech or Moderna any different? Elsewhere too, how is that of Sputnik V vaccine in Russia or AstraZeneca vaccine in the UK any different? It is scary when you are told there is no alternative solution to a problem.
Even people in authority seem to be missing something. We hear of listening to science. But whose science: is it the science of a profit-making company? They tend to politicise the issue too. That played out in the last US election. There was no good reason for criticising the use of hydroxychloroquine by some, as was vehemently done. It was a suggested option. Its consideration could expand the policy landscape and could make a positive difference. During crisis time, it is only wise to put all potential solutions on the table. Historically, the first antibiotic was tried on wounded soldiers on the war front during World War II. I believe that the logic was that, if nothing was done, the soldiers would still have died anyway. So what difference was it going to make if the antibiotic was used and the wounded soldiers still died? But the antibiotic worked. It saved lives. So, the world had Penicillin as a breakthrough antibiotic, which was accidentally discovered by Alexander Fleming, a bacteriologist and medical researcher at about that period.
Scientists today are therefore expected to research into hydroxychloroquine and see if there’s a medical sense in it for the treatment of COVID-19. The Dexamethasone popularised by Eli Lily in the US may very well have upset some vaccine companies, fearing it might take the wind out of their sail. From purely medical perspectives, Dexamethasone is a corticosteroid anti-inflammatory drug that could be recommended for COVID 19 patients as it also reduces oedema (pooling of fluid). Going by documented reports, it was found to have slowed down the infection and hastened the recovery by some days, meaning that it saved lives too. The politics against it in the US is shameful. It did not consider that the word of a General is final even when there is an adviser at the war front.
Now, why are REGENERON’s Casirivimab and Imdevimab neutralising antibody cocktail not in use, in the US even after receiving emergency use authorisation? It is surprising that people failed to see much prospect in it. This product, according to reports, is the first treatment of any kind to have prospectively confirmed any statistically significant anti-viral activity against SARS-CoV-2. It has been authorised for recently diagnosed, mild to moderate COVID-19 in high-risk patients. It has been successfully used on President Donald Trump during his four days of hospitalisation before the end of their rounds of presidential debates and subsequent rigorous campaign trips. It is disappointing if the world failed to see the usefulness from this high profile case! That is worrisome.
Lastly, many people, especially the environmental activists, hate to hear anything genetically modified organisms (GMOs) in food, and that is how far they know. But two of the trending COVID 19 vaccines from the US (Pfizer/Biontech and Moderna) were produced with the same technique, which even makes it faster to bring to the market. In China, health officials using a different technique at first have reportedly recently urged companies to look again at the new technology of Pfizer/BioNTech and Moderna after hearing of the results of speed and efficacy from these US companies. The world is therefore gradually getting locked in to the mRNA vaccines in which the viruses, rather than inducing your body to produce antibodies by their presence in inactivated forms, would now use your body cells to produce the virus parts for producing the antibody. In simple terms, the virus in the vaccine uses your body cells to replicate its components to produce the antibody. It does not sound that simple. The active ingredient, which is called messenger RNA (mRNA) carries instructions for making spike protein from the virus. This spike protein is used to gain entry to your body cells, which now becomes a machine factory of sorts. Medical scientists still have scanty evidence to prove the lasting safety of such a measure on the whole body system.
A major reason why end users are guinea pigs is better explained by an extract from MedScape, a medical resource channel, stating that one of the limitations of effectiveness of mRNA vaccines is the caveat that they “may not protect all vaccine recipients.” In a simple explanation, out of hundred people receiving the vaccine, many recipients may not even be conferred any protection at all. The percentage may vary from place to place, race to race, gender to gender, age to age, and so on. So, who knows the individuals that will not be protected? The fact that much is yet to be known about the vaccines means it is a global experiment. Moreover, MedScape pointed out that “there are no data available on interchangeability of this vaccine with other COVID-19 vaccines, meaning that the one produced in China may not protect the same way as that from the US, UK or Russia. So, those taking such a vaccine are taking GMOs and the genes sequenced into each of them may differ from one candidate vaccine to another. What people are not told is the invasiveness of such a vaccine in the process of the so-called protection, which may arise from the penetration of the spike proteins of the virus into cells that are turned into living body vaccines. The results of safety tests on them cannot be said to be conclusive as we are yet to exhaustively document the array of adverse reactions to expect from them.
Lately, there has been a flurry of activities between COVAX (described as the vaccines pillar of the Access to COVID-19 Tools Accelerator), the Coalition for Epidemic Preparedness Innovations (CEPI), GAVI vaccine alliance and the World Health Organisation (WHO) on mass vaccination. But, in the meantime, it is safer to view vaccination campaign with a lot of suspicion and misgivings. A commercially-motivated initiative launched on the floor of the World Economic Forum in Davos may be more appealing to business concerns or development theorists and tempting to populist politicians, but not necessarily the most appealing and single solution to a crisis of this sort, even if it has some merits. Good policies warrant thoughts about alternatives; not the straitjacket approach presently being promoted. The world as a whole deserves a better deal. People should be given alternatives. It is not a good idea to railroad people into one choice (like only this option or none at all). It is a period of emergency. But it is also a period that calls for sound discretion. The world is in for greater surprises ahead.
Dr Oyeleye is a public health veterinarian, policy analyst and communications expert