In the Philippines, the national Food and Drug Administration (FDA) has followed the World Health Organization (WHO) edict that the current ivermectin research targeting COVID-19 is inconclusive, hence the formal government stance here in this Southeastern Asian nation of 110.6 million is to not allow the use of ivermectin as a treatment for COVID-19 unless its for research or compassionate use. President Rodrigo Duterte has generally supported the FDA’s stance, according to the local press. But five hospitals now have received compassionate use exceptions by the nation’s drug regulator, receiving shipments of ivermectin to treat patients. And there is growing demand by front line doctors here to access the drug. A key challenge in developing countries such as the Philippines is that the income distribution is highly unequal, with a very large economically struggling population. As the pandemic spiked here starting in March and a purported mass vaccination program has proceeded slowly—only about .03% of the population is fully vaccinated—therapeutic options are of paramount importance. While the drug remdesivir is authorized for the population, the price tag precludes most of the population; it’s incredibly expensive here—available only for the rich or upper middle economic strata. Meanwhile, the great majority of lower income people have nothing, hence they increasingly plead for access to ivermectin. And recently, a group of outspoken front line doctors took some pressure and criticisms for not only demanding to treat COVID-19 patients with the anti-parasite medication, but actually conducting an ivermectin treatment event, backed by some local elected representatives. One of those representatives went to the press recently, asking authorities to “spare” the doctors as they are simply performing their Hippocratic oath.
What is going on in the Philippines?
By early March, this Southeastern Asian nation was hit by the worst wave of the COVID-19 pandemic, recording 15,298 cases on April 2 alone. The number of infections per day has started declining again, but the numbers are still far higher than for most of the pandemic. Just over 90 people are dying from the coronavirus per day. This mobilized doctors to start looking at other options.
In developing nations such as the Philippines, the vaccination process will take time and, consequently, low cost therapeutics are desperately needed for the population. For example, this nation with 110.6 million people has only seen 1.6 million people (1.5%) receive one dose and 284.5K (0.3%) with full vaccinations, according to Philippine national statistics.
While the country does have a mass vaccination program ongoing—this nation’s Food and Drug Administration (FDA) issued emergency use authorization to Pfizer/BioNTech, AstraZeneca/Oxford, Sinovac, Sputnik V, Johnson, and Johnson and Covaxin—and several others on order at various stages of development—this has not translated to the levels of vaccination sought by authorities. But supply chains, distribution, storage and the like may not be as efficient here as might be the case in North America or Europe.
Front Line Doctors & Local Representatives Sponsor Ivermectin Prescription Event
Recently, Anakalusugan party representative Mike Defensor and Sagip Rep. Rodante Marcoleta, along with a group of doctors ,organized an event called “community pan three” to prescribe ivermectin to the local population in the Quezon City area. Hailed as an “ivermectin event,” not surprisingly, this treatment gathering has triggered a critical government eye with the FDA and Department of Health looking carefully at legal violations.
Representative Defensor went on the record that the doctors should be spared, arguing that they ““…have put their names and practice on the line for the love of our people and nation.” The elected official continued, “They didn’t have to do that. They could have remained quiet and toed the line. They spoke and they acted knowing that silence will lead to the death of our people. They were just being true to their Hippocratic oath!”
While the WHO and hence the Philippine Department of Health and FDA suggest there is not enough data yet for broad off-label usage, the prescriptions at this event were apparently done so improperly, without “proper identification of a regular prescription, such as doctor’s name, license number, and Professional Tax Receipt Number.” Meanwhile, Rep Defensor declared they do have the proper records associated with the event and even submitted the information prior to the start.
Apparently, Health Secretary Francisco Duque III is investigating this event and recently requested those who are receiving the drug to report any adverse events, reported by Maricel Cruz with the Manilla Standard.
The Rich Get Their Treatments but What About the Poor?
As one can imagine, in the developed world it often is the case that the rich and powerful secure their vaccines first while those that are supposed to go first—front-line workers, members of at risk populations, etc.—are passed by.
Mike Defensor went on the record that the poor needed access to inexpensive therapies in response to the pandemic wave, commenting, “because the drugs the DOH and the Food and Drug Administration are promoting are for the rich.”
The elected official emphasized that remdesivir, an authorized therapy, costs from P12,000 ($248.86) to P48,000 (995.44) per vial, and the regiment requires two vials a day. Ivermectin costs P35 (0.73) per tablet, and only one tablet is needed daily.
He emphasized that “The DOH and FDA are allowing the use of remdesivir, while cracking down on ivermectin. Their bias is for the rich and against the poor.”