The Medical Association of Jamaica (MAJ) has apparently been doing their homework on the generic drug ivermectin and now have called on the Ministry of Health and Wellness to accept that drug into the protocols for the management of SARS-CoV-2, the virus behind COVID-19. Issued via a recent statement, the COVID-19 crisis has showed up with a vengeance in this scenic Caribbean island nation as the number of cases significantly spiked starting in February of this year. Now at a crisis point in the pandemic—total cases, hospitalizations, and deaths on the rise—MAJ wants to do something while awaiting the mass COVID-19 vaccine program. With hospitals approaching or at full capacity, MAJ believes that the government should authorize, at least on an emergency basis, the use of ivermectin, of course subject to the discretion of qualified, licensed physicians for both prophylaxis and early therapy to reduce disease progression and hence hospitalization, severe disease and death. With 3 million people and spiking cases, mass vaccination (up to 450,000) won’t occur till at least he end of 2021. Something needs to be done soon. The pandemic conditions here, for many months not too severe have turned bad as high spike commenced in the new year leading to over 20,000 cases and over 400 deaths—many more are imminent.
Not Just Fun in the Sun
The unfortunate rise in cases has caught many by surprise here, but the crisis is very real with capacity near or present in hospitals. Some are ever more critical of local culture, or sub-culture more appropriately, associated with an easy fun in the sun lifestyle. A local politician has come out and declared that the spike of cases is the result of “rampant indiscipline” on display by individuals exhibiting “scant regard for the COVID-19 health and safety protocols.” Dr David Stair was on record recently at a ceremony: “This crisis we face, ladies and gentlemen, is real, it is not only a health issue but it also affects the economy even more significantly, and also it has exposed the glaring indiscipline that exists in our society.” The local authority was critical of a certain “looseness” of Jamaican society and “refuses to conform to rules and regulations.”
The ivermectin controversy or even what TrialSite refers to as ivermectin wars intensifies as mounting evidence suggests the low cost, widely available generic drug shows come significant efficacy in treating the novel coronavirus. Several nations have now authorized the use of the drug for the indication of COVID-19, including three European Union nations of Slovakia, Macedonia and Bulgaria. Regions in Brazil and India have used the treatment for some time now with local authorities declaring results. Most recently, a prominent group of international researchers and scientists in the United Kingdom came together for the British Ivermectin Recommendation Development (BIRD) panel—the group issued sweeping recommendations for the immediate global use of ivermectin, sharing these with the World Health Organization (WHO).
As reported early in the month by the Ministry of Health and Wellness, Jamaica will access COVID-19 vaccine product via the COVAX facility for low to middle-income countries (LMICs). The Jamaica Ministry of Health and Wellness, Dr. Christopher Tufton, reported to Parliament in early in February that this island nation can access from 146,400 to 249,600 doses of the AstraZeneca vaccine (AZD1222/Oxford) from mid to late February 2021.
The access to what is known as the “Oxford” vaccine is subject to a number of political and market forces. The actual product is manufactured by India’s Serum Institute of India (SII) and SK Bioscience and assumptions of availability and capacity is based on the latest communications from them. Other factors impacting access include the WHO Emergency Use Listing.
Jamaica is not a rich country and cannot use money and market position to get to the front of the line. So even if this shipment does arrive, Tufton share,d “This means that some 125,000 Jamaicans could receive vaccines by the end of February into March. Among those to receive the vaccines are our frontline workers, including our nurses and doctors and then to our vulnerable persons, chief among those are persons 60 years and older.”
The Minister hopes that they can vaccinate 450,000 Jamaicans by the end of the year. But this cannot happen until some “preparatory steps” occur, such as ensuring “the necessary indemnity and liability frameworks in place to complete the agreement directly with AstraZeneca, as well as finalizing other procurement matters with the COVAX Facility Management.”
Now Medical Association of Jamaica (MAJ) seeks to become another nation that authorizes the use of this generic, well-known tropical drug mostly used to combat parasites. This group evolved out of the BMA Jamaica Branch, which was constituted as the first overseas branch of the British medical Association back in 1877. Once Jamaica secured its independence from the British, the Medical Association of Jamaica was formed to replace that previous association.
With over 2,000 members (representing all practices and specialties and med students), this umbrella organization includes all underlying medical professional organizations and societies in this island nation. This group offers a wide range of advisory services from health sector reform to continuing medical education seminars and workshops, insurance and more.
Call to Action: What are your thoughts? Jamaica avoided any serious SARS-CoV-2 infections for quite a while. The reality is that for poorer nations, there is no front of the line for vaccination. The case for ivermectin grows based on the safety and efficacy data. The U.S. National Institutes of Health is helping to support numerous studies for advanced therapies and prophylaxis while vaccination programs roll out. Shouldn’t a low cost, generic option be considered as well should it be proven to be safe and effective?