Ivermectin: A Nobel Prize medicine inaccessible to the world’s poorest

DISCLAIMER: All opinions in this column reflect the views of the author(s), not of EURACTIV.COM Ltd.

A young boy is given de-worming treatment in the Central African Republic. [hdptcar/Flickr]

The true potential of new medical breakthroughs can only be unlocked if they are offered at an affordable cost to those who need them most, writes Jose Muñoz.

Dr. Jose Muñoz is a specialist in tropical medicine at the Hospital Clinic of Barcelona, Spain. He is also a researcher at the Institute for Global Health in Barcelona (ISGlobal).

This opinion editorial was first published by EURACTIV’s partner El País – Planeta Futuro.

Japanese biochemist Satoshi Omura and American biologist William C. Campbell were jointly awarded the 2015 Nobel Prize in Physiology or Medicine for their discovery of the avermectin group of compounds over 30 years ago. A derivative,  ivermectin, is best known for its broad effectiveness in treating parasitic worms, which cause some of the planet’s most neglected diseases. It is used to treat millions of people at risk of contracting devastating illnesses such as river blindness and lymphatic filariasis, as well as playing an important role in the control of intestinal helminths (parasitic worms).

Due to its safety and broad spectrum, the World Health Organisation (WHO) catalogue ivermectin as an essential drug and it is seen as somewhat of a ‘magic bullet’ for safeguarding global health. Its effectiveness in fighting many diseases associated with poverty makes it a prime candidate to be one of the next breakthroughs in global health, because of its potential to improve the quality of life and lower mortality rates in the globe’s poorest countries.

>>Read: Nobel awards discoveries in fighting malaria and roundworm

The picture is far from perfect however, because a ‘magic bullet’ requires a ‘magic gun’ to fire it. Unfortunately, ivermectin is not currently available to everyone who needs it. Since the 1980s, ivermectin has been made available to treat river blindness and lymphatic filariasis in endemic areas thanks to the donations of Merck, the pharmaceutical giant. However, it is not marketed, and is very expensive in most countries where it is needed to treat other parasitic infections.

In particular, the drug is not available to treat human strongyloidiasis, another neglected disease, despite ivermectin being considered the number one option for treatment. The disease is thought to affect more than 30 million people worldwide and is particularly dangerous for people who have reduced immunity.

One of the main reasons that access to the ‘magic bullet’ is not widely available is because the diseases it targets are so-called neglected diseases. This group of diverse medical conditions are characterised by their high prevalence in low-income, tropical and subtropical countries, in addition to the relatively low levels of investment and research that go into them.

Generally, the pharmaceutical industry does not see this as an economically attractive area in which to develop and expand. In the case of ivermectin, these harsh realities have limited viable access to the drug, beyond donations that are restricted to certain countries for the treatment of certain diseases. Its high cost also makes it an unrealistic purchase, given that the people who most need the drug often earn on average $2 a day.

There is still enormous untapped potential in the drug, particularly in its use in the treatment of neglected diseases and its potential use in malaria control, as it is capable of killing mosquitoes that feed on the blood of people who have been treated with it. It is of the utmost importance that large-scale initiatives are launched to investigate new applications of ivermectin and to report on its efficacy and safety.

>>Read: Dams create breeding grounds for malaria in Africa

However, the first step is to develop policies that provide access to this miracle drug and to establish a reasonable price, so the people who suffer most from diseases that are preventable by it are not priced out of their right to a healthy life. Such political action is needed to improve the lives of millions of people, especially schoolchildren. The true potential of the discovery made by professors Omura and Campbell will only be unlocked through these kinds of measures.

>>INFOGRAPHIC: Not all SDGs were created equal

Today (21 October), the “It’s not healthy” campaign (“No es Sano”) was launched in Madrid, which aims to ensure universal access to medicines. Efficient and sustainable medical research is one of its key objectives.

The global community must act to make sure that essential medication is available and affordable to those that need it most, regardless of where in the world they live. The recently adopted Sustainable Development Goals include a number of targets that will go some way to achieving this, if the world’s nations take the necessary steps.

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