Ivermectin Advocate Professor Colleen Aldous recently attended the College of Primary Health Care Physicians of Zimbabwe and was stunned by yet another unfathomable decision by authorities on the treatment of Covid-19. Highly reputable doctors have recounted their use of ivermectin to successfully treat Covid-19. But at the conference, the National Advisory Committee on Medical and Therapeutic Policy announced that vitamin C, vitamin D and zinc were grouped with ivermectin as drugs not recommended for the treatment of Covid-19. As Professor Aldous points out below, “the diet that many doctors had used successfully during the pandemic has been crushed”. – Nadya Swart
Zimbabwe advisory committee bans use of vitamins for Covid-19 treatment
By Professor Colleen Aldous*
I am always amazed that the authorities manage to descend even further after reaching what we believe to be their lowest point!
Last week, I attended the CPCPZ/PSZ* Joint Annual Congress 2022 in Victoria Falls. I have been invited to speak on evidence-based medicine (EBM) as part of the conference theme, “Active Adaptation to Emerging Challenges in Health Care Delivery: Lessons Learned from the COVID-19 Pandemic”. At the conference, Dr. Sabine Hazan presented the Covid-19 treatment regimen she implemented in Malibu, California, which included ivermectin. Dr. Jackie Stone from Zimbabwe presented the results of his treatment regimen, which also included the drug. Dr. Hazan has treated over 3,000 patients with zero mortality. Dr. Stone only lost six out of several hundred patients, who died when they were hospitalized and their diets changed. The two doctors kept their patients out of hospitals, treating them at home – until Dr Stone was no longer allowed to use his regimen.
My jaw dropped when Dr Edward Chagonda, a Zimbabwe football team doctor and specialist family physician who teaches in the University of Zimbabwe’s Family Medicine Program, presented the draft Covid-19 treatment guidelines for the Consultative Committee. This committee had previously asked the CPCPZ for its Covid-19 treatment guidelines. They were handed over enthusiastically in the hope that they would make a positive contribution to national guidelines.
Imagine the shock of the public, all members of CPCPZ and PSZ, when they saw that the guidelines were taken directly from the WHO guidelines, which includes molnupiravir as an antiviral, a drug with 50% efficacy for progression to severe disease compared to ivermectin’s 66%. The WHO recommended list of drugs for Covid-19 is unaffordable for the average Zimbabwean. Each drug in the CPCPZ protocol has been listed under drugs not recommended for use in the treatment of Covid-19. Predictably, they threw ivermectin off the list, but vitamins C, D, and zinc? It was clear that the CPCPZ protocol had been requested in order to list all the drugs in their regimen as specifically not to be used – the regimen that many physicians had successfully used during the pandemic was crushed. I don’t believe the list was thought through at all. It looks like it was just copied and pasted from the CPCPZ scheme. It is unheard of that a doctor should not prescribe at least vitamins and zinc to a Covid-19 patient: over-the-counter drugs.
There are two groups of healthcare professionals involved in the treatment of Covid-19.
First, there are primary care physicians or general practitioners who have applied for permission to use ivermectin from the Zimbabwe Ministry of Health. Permission was granted with a clause to provide treatment data to the ministry as part of an ongoing research project. This is the data that should be provided to the department. I worked with Dr. Jackie Stone on a journal article that was accepted for publication showing the immediate improvement in oxygen saturation after starting his ivermectin regimen. Data from other doctors in Zimbabwe who have used ivermectin will be considered anecdotal evidence as it is not in the form of a randomized controlled trial. But after Dr. Stone’s arrest and subsequent legal tribulations over his diet, many doctors remained silent about their use of ivermectin.
Secondly, there is a group of medical specialists who have a very different approach to treatment. They expressed their rejection of the primary care physician protocol. According to one of the conference delegates, “Unfortunately for Zimbabwe, medical specialists are considered mini-gods, but to me their recommendations would mean that no one will receive treatment for Covid-19 just because patients don’t won’t be able to afford it (sic) Their treatment guidelines and recommendations are regurgitated by the WHO.
Then there are the sick. They are not all as gullible as some might think. They will take treatments they believe in, whether the authorities like it or not. The majority of Zimbabweans will not be able to afford the treatment offered and will not wait for the disease to progress without taking treatment. They prefer to self-medicate, including with ivermectin.
Dr. Chagonda sat on the advisory committee that wrote these guidelines and told the audience that these guidelines would be enforced as nudity would be imprisoned. I am not joking; it was his metaphor. Although there was an effort to get these guidelines through quickly, the draft document was referred to the Covid-19 Treatment Guidelines Committee for input from all stakeholders, especially family doctors and pharmacists. , who happen to be the frontline workers in the fight against Covid19. The Ministry of Health has been rational in waiting for contributions from doctors who have successfully treated Covid-19. They postponed signing the guidelines until that was done.
My presentation on EBM, which immediately preceded Dr. Chagonda’s presentation, has, I hope, made an impression. I presented the EBM pyramid and intersection diagrams and explained what research on the reuse of drugs such as ivermectin is appropriate in a pandemic. I showed what research for and against the use of ivermectin in Covid-19 is currently published and what was available when the WHO declared Covid-19 a pandemic. I insisted on considering the totality of evidence, not just the narrow focus on randomized controlled trials. However, there is still this indoctrination among some who I believe are determined thinkers, not growth thinkers, who say that only a large randomized controlled trial can persuade them before they will admit that a drug works. Until then, there is apparently not enough evidence for them. I also pointed out that Africans understand their own problems better than any superpower and that we should use our own brains to solve our own problems in a way that we know works in our contexts.
I had been in Victoria Falls for five days and did not see an elephant. Dr. Hazan told me she saw one on the road outside a restaurant she was at. Dr. Stone says she never went to the falls for more than 24 hours without seeing one. There were old and fresh elephant droppings all over town. I saw the track of a baby as well as a lone male elephant. I’ve seen baobabs wrapped in diamond fences to protect them from elephant damage. All anecdotal evidence! I had yet to see an elephant in Victoria Falls. Seeing is believing. Therefore, I divulge with the confidence of the Advisory Committee that there is insufficient evidence of elephants in Victoria Falls for me to recommend that you go there to see them.
*CPCPZ/PSZ – College of Primary Health Care Physicians of Zimbabwe/Pharmaceutical Society of Zimbabwe.
- Professor Colleen Aldous is a health scientist at the UKZN College of Health Sciences, where she heads the Doctoral Academy. She is a Fellow of the Academy of Sciences of South Africa. She holds a Ph.D. and has published over 140 peer-reviewed articles in listed journals.
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