All Abuzz About an Anti-parasite Drug

As Southeast Asia continues to fight fresh waves of the Covid-19 pandemic, a needlessly divisive debate has been gaining ground on regional social media concerning the use of an anti-parasite drug to treat the coronavirus. Proponents of ivermectin say that the well-established off-patent drug is cheap, safe and has helped to dramatically lower hospitalisation and death rates for Covid-19 patients. Opponents say that the data on ivermectin’s efficacy remains inconclusive and that the advocates of ivermectin are undermining the global vaccine drive by touting unproven alternative therapies, in defiance of the World Health Organisation (WHO) guidelines. 

Indeed, the original debate around ivermectin’s efficacy in treating Covid-19 has since morphed into several other narratives. Some conflate ivermectin advocacy with the anti-vaccine agenda, given that claims around ivermectin’s “miraculous” efficacy could nullify the need for Covid-19 vaccines. Other narratives centre around Big Tech’s collusion with Big Pharma to censor scientific debate on the viability of cheaper, “non-profit” drugs. Such narratives, which originated in the US, have found resonance in Southeast Asia, notably in the Philippines, Indonesia and Malaysia. 

ISEAS’ analysis of social media buzz in the region between March and June indicates that buzz around ivermectin first took root in the Philippines, followed by Malaysia and Indonesia. (See Figures below.) 

Significantly, the sharp peaks in ivermectin social media buzz in the Philippines and Indonesia coincided with news that prominent political figures had decided to champion the use of ivermectin for the therapeutic treatment of Covid-19. 

Common across the regional narratives around ivermectin is the strong public clamour for access to effective Covid-19 treatments. For ivermectin advocates, the benefits of using ivermectin as an option for treatment must surely outweigh the risks.

In the Philippines, buzz around ivermectin spiked in early April following news that congressman Mike Defensor intended to distribute ivermectin free to his constituents. The subsequent spikes in ivermectin buzz coincided with news that Defensor intended to fight the Food and Drug Administration in court if it blocked his plans for ivermectin distribution. Defensor’s initiative was swiftly criticised as an opportunistic political stunt aimed at positioning himself for the next elections. The strong demand for access to ivermectin in the Philippines has led to concerns over the unauthorised sale of the drug on the black market. 

In Indonesia, the social media buzz around ivermectin spiked only recently in late June, coinciding with news that Minister for State Owned Enterprise Erick Thohir supported the ramping up of local ivermectin production and the use of the drug for therapeutic treatment of Covid-19. News of Presidential Chief of Staff Moeldoko’s strong support for ivermectin probably added to the buzz. He was quoted in the media as stating that he had recently facilitated the distribution of thousands of doses of ivermectin to various red zones across Indonesia. 

In Malaysia, the ivermectin buzz appears to have centred around lobbying the government to consider adopting ivermectin into Covid-19 treatment protocols. Malaysian media reported on 23 June that the Malaysia Muslim Consumers Association (PPIM) lodged a police report against the Health Ministry for refusing to use ivermectin to prevent the spread of Covid-19. Separately, a group of medical and consumer-related NGOs known as the Malaysian Alliance for Effective Covid Control also petitioned the Health Ministry to immediately approve ivermectin for Covid-19 treatment outside of clinical trials. (The Health Ministry had announced in early June that a clinical trial on ivermectin’s efficacy has started at 12 government hospitals.) 

Common across the regional narratives around ivermectin is the strong public clamour for access to effective Covid-19 treatments. For ivermectin advocates, the benefits of using ivermectin as an option for treatment must surely outweigh the risks. This is particularly true for countries still battling fresh waves of Covid-19 infections and facing shortfalls in vaccine supply and healthcare capacity. Such sentiments are probably symptomatic of a deeper undercurrent of fear, anxiety and battle weariness within society, where there is an almost desperate need for some hope in the battle against Covid-19. Ivermectin advocates have underscored the fact that ivermectin is cheap, safe, readily available and has shown promising results. 

Public health officials may well be more hesitant. But the challenge is how to explain their views while preventing the debate from becoming toxic and politicised, as has happened in the US. In Chris Bail’s new book Breaking the Social Media Prism: How to Make Our Platforms Less Polarising, he encourages the typically reticent and conflict-avoidant moderates to speak up in order to prevent extremists from hijacking the discourse. The irony, in this case, is that the original advocates for ivermectin, who have now been joined by many in the anti-vaccine camp, are hardly fringe conspiracy theorists nor radical anti-vaxxers. 

Dr Paul Marik and Dr Pierre Kory are both prominent and experienced pulmonary and critical care specialists. They saw marked improvements in their Covid-19 ICU patients after administering ivermectin. But they quickly became unlikely activists when they found themselves censored for allegedly touting unproven therapies, contradicting WHO guidelines. The two specialists are founders of the Frontline Covid-19 Critical Care Alliance (FLCCC), a group formed in March 2020 to research and develop protocols for the prevention and treatment of Covid-19. 

During his testimony before a Senate committee on the medical response to Covid-19 in December 2020, Kory complained that “every time we mention ivermectin, we get put in Facebook jail”. He and his FLCCC colleagues now spend much of their energies battling, among other things, the over-zealous content moderation by social media platforms in addressing Covid-19 misinformation. It is likely that Kory and his team are brushing up against cancel culture practices from the US’ pro-vaccine wing and Big Pharma.  

For Southeast Asia, it remains crucially important not to fall into the trap of false dichotomies in public discourse. The focus of the ivermectin debate should remain squarely on its effectiveness as a therapeutic treatment for Covid-19. With more clinical trials currently underway, a clearer verdict on ivermectin will eventually emerge. But the challenge for public health officials is deciding whether they have the luxury to wait. This requires wisdom and the ability to accurately weigh the benefits against the risks.

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