The Southeastern nation of Malaysia recently announced the planning for a major clinical trial to evaluate two low cost, widely available, orally administered generic drugs targeting early onset COVID-19, including Favipiravir and Ivermectin. Developed by Japan’s FUJIFILM Toyama Chemical Co. Ltd., Favipiravir (Avigan) is approved in Japan for influenza and under review by the Japanese health authorities for treating COVID-19. However, the antiviral has been approved for use against COVID-19 in several nations, including Russia, India, as well as use in China. TrialSite chronicles Ivermectin developments closely and suggests this recently announced study sounds similar to the PRINCIPLE Trial out of University of Oxford, which will test the same two treatments. Dr. Noor Hisham Abdullah reported that the nation’s Institute of Clinical Research coupled with infectious disease specialists from the Ministry of Health have a keen interest in understanding the benefit of the therapies.
Did it Start with a Malay Tweet?
Recently, the Director-General of Health for this archipelago nation of 878 islands tweeted, “Ivermectin & COVID-19” communicating, “Oral Ivermectin is listed under WHO essential medicines, primarily as an anthelminthic drug used to treat various parasitic infestations.”
Dr. Abdullah’s tweet led to his Facebook page, which apparently is a platform for this important figure in Malaysia health circles to communicate updates. And that he did. Sharing the background and backstory of Ivermectin, from introducing its broad spectrum antiviral properties against RNA and DNA viruses, noting already “some clinicians have repurposed Ivermectin with other standard of care against COVID-19.”
The director of the nation’s health agency further noted the observational studies and case series as well as offered a link to Dr. Carolos Chaccour’s recent findings from his small Spanish trial, which emphasizing the results warrant further exploration. Dr. Chaccour, a world renowned Ivermectin expert, has appeared on TrialSite’s podcast.
Highlighting the power and influence of the U.S. National Health Institutes (NIH), Dr. Abdullah refers to the NIH COVID-19 Treatment Guidelines, which of course was recently updated. The official stance: “there is insufficient data to support the use for prophylaxis or treatment of COVID-19.”
The Malaysian director probably isn’t aware of is that the Front Line COVID-19 Critical Care Alliance (FLCCC) presented to the NIH COVID-19 Treatment Guidelines panel just recently. Days later, (Jan 14) they issued an update from not recommend except for clinical trials to “…there are insufficient data to recommend either for or against the use of Ivermectin for the treatment of COVID-19.” Not noticeable by many but a subtle change in position by the most influential apex research body in the world.
Also referenced is the Australian’s New South Wales (NSW) Health’s COVID-19 Critical Intelligence Unit Ivermectin and COVID-19 “Evidence Check” which much like the NIH, declares there’s insufficient evidence at this point for use of the drug as a treatment targeting COVID-19. Much like South Africa the state-based agency seems select with the trials they review and their opinion is of course markedly different than that of the FLCCC’s Ivermectin and COVID-19 meta-analysis.
Malay Clinical Trial in the Works
Now Malay government health representative reported that “The Institute of Clinical Research and KKM Infectious Disease specialists are in the process of developing a clinical trial on IVM, as well as Favipiravir to further ascertain the efficacy of these medicines. We shall update the outcome in due court.” Public health typically doesn’t see much emotional responses but this particular entry led to 1.5K likes and 62 comments as of this writing, including mentions to Dr. Pierre Kory of the FLCCC.
About the Malaysian Institute for Medical Research
Under the Ministry of Health in this country, the Institute for Medical Research represents the apex research body for the nation. The genesis of the IMR goes back to 1900 when Sir Frank Athelstane Swettenham, the then Resident-General of the Federated Malay States recommended the introduction of a Pathological Institute in the then Malaya to carry out scientific and sustained research into the causes of relevant tropical diseases of the time including Malaria. The IMR has continued to evolve from its initially focused beginning operating under the British influence till the formation of the “Malayan Union” in 1946 and ultimately modern Malaysia (full independence 31 August 1957).
The IMR makes ongoing contributions to biomedical research especially in the field of tropical diseases with an emphasis on beri-beri, malaria, cholera, typhoid, smallpox, leprosy, TB and many more. Presently, the IRM emphasizes research as well as specialized diagnostic services, training and biomedical technical consultancy. The IMR operates via nine centers.
Director-General Ministry of Health Profile
A surgeon specializing in oncology, he has most recently operated out of Putrajaya Hospital and has served the nation as Director-General of Health since March 2013. Prior to this appointment, Dr. Abdullah was the Deputy Director General (Medical) between 2008 and 2013.
A key opinion leader in this part of the world when it comes to breast and endocrine cancers, Dr. Abdullah has published numerous papers, and textbook chapters in endocrine surgery. He was trained in breast and endocrine surgery under the Royal Australasian College of Surgeons Fellowship training program and obtained his Master of Surgery and Medical Degrees from the University of Malaysia.