Botswana’s Ivermectin Dilemma

  • “Forget the laws, we are in a war-like-crisis, people are dying” – Ex Health Minister Sheila Tlou
  • Pressure groups push Gov’t to grant permission
  • Former Health Ministry PS calls for caution

Former Minister of Health, Professor Sheila Tlou’s call for the use of Ivermectin to treat COVID-19 has added to the mounting pressure on government to sanction the immediate use of the controversial medicine in the midst of Botswana’s worst COVID-19 wave.

The Delta variant has wreaked havoc on Botswana’s small population, landing the country in the number two spot globally for infections per one million people. As the harsh realization of losing loved ones mounts, the World Health Organization (WHO) still advises the use of Ivermectin against COVID-19 only within clinical trials. WHO states that the current evidence to treat COVID-19 patients is inconclusive.

“Evidence on whether Ivermectin reduces mortality, the need for mechanical ventilation, the need for hospital admission and time for clinical improvement in COVID-19 patients is of very low certainty due to the small sizes and methodological limitations of available trial data. Until more data is available, WHO recommends that the drug only be used within clinical trials,” say WHO.

Professor Tlou took to social media this week to advocate for Ivermectin as an alternative to the slow vaccine roll out. This week she doubled down on her position. “People are dying. We are in an emergency here. A war-like-crisis is upon us and we must act immediately with what works and what works is Ivermectin as endorsed by several doctors and scientists on the ground,” she said in an interview.

“There are calls for the use of Ivermectin at community level and even by some doctors saying it may not be perfect, but at least it does help in many cases. What I see happening on the ground, especially here in South Africa where some doctors are prescribing the drugs to their clients, the results have been very good hence the low death rate,” she said.

“My problem is that whereas here the doctors prescribe it and is therefore taken under safe conditions, Botswana does not allow doctors to give it, yet some people are using it and may even buy it through unsafe outlets. If the situation is not resolved, we will see lots of drug overdoses and counterfeit drugs, and now that would be a real disaster.”

But Dr Edward Maganu, former Permanent Secretary in the Ministry of Health differs. “The medical profession works through the manual handbook which states that every drug must be scientifically proven and approved by regulatory bodies and Ivermectin has not yet be approved. Yes, we are facing decimation but my advice would be that any doctor who resorts to it must make his or her patients sign a consent form after explaining the decision to issue it,” he said in an interview. Maganu is a Health Care and Health Systems expert, with experience in Disease Control, Health Services Management and International Health. He has worked for the Ministry of Health and WHO.

Despite showing a willingness to engage pressure groups and help facilitate trials in Botswana , the assistant Minister of Health and Wellness, Sethomo Lelatisitswe says Botswana still recognizes WHO as the authority. Responding to Parliamentary questions, the Assistant Minister claimed that although the government is aware of the usage of the drug in some countries, he is not aware of it in Botswana.

“The government is aware of countries that use Ivermectin for both cure and prevention of COVID-19, despite no scientific evidence. Current scientific evidence indicates that the use of Ivermectin should only be used on clinical trials. For us to allow any medication, we rely on scientific evidence and the green light from Botswana Medical Regulatory Authority (BOMRA). Currently I can confidently reveal that BOMRA has not licensed the Ivermectin to be used in the treatment of COVID-19.

If there is anyone using this drug they should know that they are doing that at their own risk,” Lelatisitswe said in parliament.

The recent offer from government to accept a proposal for clinical trials in Botswana has been a welcome triumph for proponents of the drug. The Botswana COVID-19 Ivermectin Intervention Group (BCIIG), which is a group of multi-disciplinary scientists, healthcare professionals and community members, has advocated for urgent consideration and use of Ivermectin and all other possible therapeutics against COVID-19. The drug, they say, has in recent times and at a minimum been used at various doses in approximately 19, 000 humans for the prevention and treatment of COVID-19 without any serious adverse effects reported.

An increasingly worried population looks to Ivermectins for an uncertain reprieve, yet it remains uncertain whether the country’s first clinical trials will be complete in enough time to stem the already destructive tide.