Greetings and peace be with you. The reason for this letter is to bring to your attention the latest review paper on ivermectin by Kory et al (2021) with the hope the MOH will seriously consider hastening the use of ivermectin both as a prophylaxis and therapeutic agent for COVID-19.

In the current situation where the infective rate is escalating, there is a pressing need to use a safe and proven medication to complement the vaccination campaign.

Four months ago in January, you mentioned that the MOH would be conducting a clinical trial to ascertain the efficacy of ivermectin. To this day we have heard nothing of the study.

Kory and colleagues have provided very clear and supported evidence regarding the efficacy of ivermectin in COVID-19 as follows:

1. Since 2012, multiple in vitro studies have demonstrated that ivermectin inhibits the replication of many viruses, including influenza, zika, dengue and others.

2. Ivermectin inhibits SARS-CoV-2 replication and binding to host tissue through several observed and proposed mechanisms.

3. Ivermectin has potent anti-inflammatory properties with in vitro data demonstrating profound inhibition of both cytokine production and transcription of nuclear factor-kB (NF-kB), the most potent mediator of inflammation.

4. Ivermectin significantly diminishes viral load and protects against organ damage in multiple animal models when infected with SARS-CoV-2 or similar coronaviruses.

5. Ivermectin prevents transmission and development of COVID-19 disease in those exposed to infected patients.

6. Ivermectin hastens recovery and prevents deterioration in patients with mild to moderate disease treated early after symptoms.

7. Ivermectin hastens recovery and avoidance of ICU admission and death in hospitalized patients.

8. Ivermectin reduces mortality in critically ill patients with COVID-19.

9. Ivermectin leads to temporally associated reductions in case fatality rates in regions after ivermectin distribution campaigns.

10. The safety, availability and cost of ivermectin are nearly unparalleled given its low incidence of important drug interactions along with only mild and rare side effects observed in almost 40 years of use and billions of doses administered.

11. The World Health Organization has long included ivermectin on its "List of Essential Medicines".

Supporting studies for the above are provided in the review paper of Kory and colleagues.

We hope Tan Sri and those involved in research in the MOH can find time to read the review paper by Kory and colleagues and take the appropriate action.

Reference:

Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19, Kory, Pierre MD; Meduri, Gianfranco Umberto MD; Varon, Joseph MD; Iglesias, Jose DO; Marik, Paul E. MD.

(Capt Dr Wong Ang Peng (Rtd) is Persatuan Patriot Kebangsaan (Patriot) public communications director, Society of Natural Health Malaysia president, Naturopathic Medicine Association Malaysia chairman and Dr Rath Research Institute researcher.)