With growing numbers of SARS-CoV-2 cases in the southeastern African nation of Zimbabwe, once known as “the Jewel of Africa,” TrialSite recently shared the entire nation was ramping up its defenses and that now includes the proactive use of Ivermectin for research purposes. That nation’s Health recently communicated to the Medicines Control Authority of Zimbabwe (MCAZ) that, “In these difficult times of COVID-19 treatment, we have to be careful to protect patients as well as not to deny them effective treatment regimens.” The ministry went on, “It is in this regard, the authority is hereby granted for you to proceed to allow importation and use of these medicines under the supervision and guidance you outlined. Ivermectin can be evaluated for both treatment and prophylaxis.” This government decree, provisional and under emergency conditions, was the result of a major spike in the number of cases and deaths in the country. With growing word of the drug’s potential efficacy, exemplified in what is now over two dozen clinical trials from multiple primarily low to middle-income countries (LMICs) the authorities here also sought to stop illicit use of the variety of the drug meant for animals. A TrialSite discussion with an MCAZ spokesman Richard Rukwata indicates the country’s embrace of a proactive research agenda involving Ivermectin. Based on available data points, it appears that the nation’s research authority now embraces a pragmatic and proactive approach to offer research as a care option targeting COVID-19 in quest to protect human life.
The Challenge: Similar to South Africa
Ivermectin for humans isn’t registered in this nation and the growing demand for the product’s use was driving an illicit black market for the veterinary variety. Apparently according to one source the covert use of the drug was spiking leading to runaway costs as a 5 millimeter shot was selling for $5 (1,809 Zimbabwe dollars) reports Anadolu Agency, Turkey’s state-run media. Seeking to overcome a growing trend of self medication (much like what TrialSite observed and wrote about in places like Peru and Bolivia) as it poses danger to humans the Health Ministry made the move to both legitimate importation of the drug for humans while in parallel imposing more controls to stop both self medication and use of the drug made for animals.
Proactive Moves to Protect the Zimbabwe Population
In TrialSite’s recent Zimbabwe piece, health regulators there were certainly lined up with most of the rest of the world not accepting any off label use till the result of clinical trials. Of course, there have been many clinical trials with over 2,000 patient records but for a few different reasons most health research bodies don’t think its enough of the right data just yet. The Anadolu Agency reports that the illicit use of the animal variety was becoming such a problem. But perhaps the true underlying rationale for an acceleration of Ivermectin investigation is the pain and grief associated with the loss of growing numbers of community members. The governmental authorities in this country are now making serious moves to investigate the anti-parasite therapy as a possible means to more wide-spread prophylaxis and early onset care.
Research as Care Option Nexus
As reported one of the nation’s largest news outlets “The Herald,” the government is also supporting ongoing research into Ivermectin. This source acknowledged that further clinical evidence would be necessary prior to acceptance for wider use. TrialSite again was able to interact with MCAZ spokesperson Richard Rukwata who reports that the agency now proactively readies collaboration with local researchers and general practitioners to conduct extensive research, which affords imminent access to patients.
TrialSite suggests that Zimbabwe could be following a similar path as South Africa, which recently opened up the compassionate use program for the drug. Based on a few interactions with health professionals including the spokesperson for MCAZ, Zimbabwe is definitely on the move, embracing a proactive research initiative—more than likely inclusive of real world evidence approaches, to help ensure that the majority of the nation’s population access treatment. TrialSite commends the efforts of the Zimbabwe Health Minister and the Medicines Control Authority of Zimbabwe for its forward thinking moves.