Does the Fate of Ivermectin As a Covid-19 Treatment Rest in the Hands of the Deeply Conflicted Bill & Melinda Gates Foundation?

One of the world’s biggest vaccine proponents and strident defender of intellectual property rights is funding, directly and indirectly, large trials into cheap, off-patent, off-label COVID-19 treatments, including ivermectin.

The evidence backing ivermectin’s efficacy against Covid-19 continues to stack up, even as most health authorities refuse to approve its use. The last two months have seen the publication of three peer-reviewed meta-analyses demonstrating clear benefits. A review by Pierre Kory et al summarised findings from 18 randomized controlled treatment trials, concluding that ivermectin produced “large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance.” Another study, led by Doctor Andrew Hill, a well-respected international medical researcher reported a 56% reduction in mortality together with favourable clinical recovery and reduced hospitalisation.

A third study, by Andrew Bryant et al, analysed the existing data from clinical trials according to conservative Cochrane meta-analysis standards — a gold-standard in science. Published in the American Journal of Therapeutics, the study found that “ivermectin prophylaxis reduced COVID-19 infection by an average 86%”. The study concluded that “large reductions in COVID-19 deaths are possible using ivermectin”, adding that “the apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.”

Still in Limbo

But national and supranational health authorities continue to drag their feet. The US Food and Drug Administration, together with the European Medicines Agency (EMA) and the World Health Organization, insist that there is still not enough good quality data to approve ivermectin as an off-label treatment against Covid. Its use, they say, should therefore be restricted to well-designed, randomised control trials.

Over 20 countries around the world, including India, Bolivia, Mexico and Slovakia, have ignored that advice and are using the medicine, to some degree or another, largely with significant success. The latest country to do so is Indonesia, which is in the grip of its biggest wave of infections to date. In most countries, however, the drug is still in limbo as their respective health authorities await the outcome of large randomised controlled trials.

The problem is that large randomised trials are prohibitively expensive, costing millions of dollars to conduct. As a result, they tend to be funded by large pharmaceutical companies seeking FDA or EMA approval for the drugs they themselves have developed. It also makes it difficult to secure new indications for generic medications that are already approved for other purposes. After all, who is willing to invest millions of dollars testing a drug that is likely to generate little, if any, financial return?

But with the world fighting a losing battle against a fast-spreading, rapidly evolving coronavirus that has sent the global economy spinning, desperate times call for desperate measures. Money has been found and mobilised. According to Hill et al, there are at least five large, placebo-controlled clinical trials on the use of ivermectin for COVID-19 currently underway.

One of them, dubbed the TOGETHER trial, is being conducted at McMaster University in Ontario, Canada. The trial has been running since last summer. The goal, according to the trial’s official website, is to “identify which repurposed therapies are most effective, in order to slow the pandemic while many countries await the delivery of vaccines.”

The trial has already tested and “dropped” hydroxychloriquine, lopinavir/ritonavir (an antiretroviral medication used in the treatment and prevention of HIV/AIDS) and metformin (an anti-diabetes medication). It is currently testing fluvoxamine (an anti-depressant), interferon-lambda (a regulator of intenstinal viruses), doxazosin (used to treat prostatic hyperplasia and hypertension) and ivermectin and will report its findings in the coming months.

There’s only one potential problem: where it gets its money.

The Together Trial has received millions in funding from three main sources: the Rainwater Foundation; Fast Grants, an American charity that provides funding for scientific research whose donors include Arnold Ventures, The Chan Zuckerberg Initiative, Jack Dorsey and Elon Musk; and last but not least, the Bill and Melinda Gates Foundation.

The Gates Foundation, as readers are no doubt aware, is one of the world’s biggest backers of vaccine research, as well as the second largest funder of the World Health Organization (WHO). It is also heavily invested in large pharmaceutical companies, including Pfizer and BioNTech, the joint manufacturers of the world’s most profitable Covid-19 vaccine, and Merck, the original manufacturer of ivermectin which has an antiviral compound, molnupiravir, in Phase 3 clinical trials for COVID-19.

As well as founding and funding the Vaccine Alliance (GAVI), the Gates Foundation is a passionate defender of pharmaceutical companies’ intellectual property rights. For months the world’s largest private foundation blocked attempts to temporarily lift coronavirus vaccine patent protections, preventing poorer countries from gaining cheaper access to COVID-19 vaccines, until it was finally forced to reverse course. As for McMaster, it is developing homegrown vaccines to fight COVID-19 in its “specialised lab and production facilities.”

In other words, an organisation that is hugely committed and invested in vaccine development is running one of the world’s largest clinical trials into one of the biggest threats facing COVID-19 vaccines: existing off-label medicines. To top it off, the trial is being part-financed by arguably the world’s biggest vaccine cheerleader whose interests are closely aligned with the world’s biggest pharmaceutical companies, some of which it is directly invested it. 

The potential for conflicts of interest is huge. If a cheap, off-patent drug like ivermectin were approved for use against COVID and if it worked as effectively and as safely as most trials suggest, it would pose a direct threat to novel treatments being rolled out by pharmaceutical companies whose safety data is no match for ivermectin’s. It could also even jeopardise the emergency use authorisation granted to the COVID-19 vaccines, one of the basic conditions for which is that there are no alternative effective treatments available for the disease. As such, if ivermectin or some other promising medicine were green-lighted, the vaccines could be stripped of authorisation.

Gaming Trials

Pharmaceutical companies have a long track record of gaming the drugs trials they themselves finance and design. Unfortunately, most trials these days are industry funded. In a 2013 article for Scientific American Ben Goldacre showed how that could dramatically skew trial outcomes. 

In 2010, three researchers from Harvard and Toronto found all the trials looking at five major classes of drug—antidepressants, ulcer drugs and so on—then measured two key features: were they positive, and were they funded by industry? They found over five hundred trials in total: 85 per cent of the industry-funded studies were positive, but only 50 per cent of the government funded trials were. That’s a very significant difference.

In 2007, researchers looked at every published trial that set out to explore the benefit of a statin. These are cholesterol lowering drugs which reduce your risk of having a heart attack, they are prescribed in very large quantities, and they will loom large in this book. This study found 192 trials in total, either comparing one statin against another, or comparing a statin against a different kind of treatment. Once the researchers controlled for other factors (we’ll delve into what this means later), they found that industry-funded trials were twenty times more likely to give results favoring the test drug. Again, that’s a very big difference.

We’ll do one more. In 2006, researchers looked into every trial of psychiatric drugs in four academic journals over a ten-year period, finding 542 trial outcomes in total. Industry sponsors got favorable outcomes for their own drug 78 per cent of the time, while independently funded trials only gave a positive result in 48 per cent of cases. If you were a competing drug put up against the sponsor’s drug in a trial, you were in for a pretty rough ride: you would only win a measly 28 per cent of the time

“Those who design the trials and control the data also control the outcome,” says Tess Lawrie, a British medical researcher and doctor who led the Bryant et al meta-analysis. “So this system of industry-led trials needs to be put to an end. Data from ongoing and future trials of novel COVID treatments must be independently controlled and analyzed. Anything less than full transparency cannot be trusted.”

Usually the goal of a trial is to achieve a favorable outcome for the drug under trial. This can be done through a number of means, including ignoring certain inconvenient data, using subjective outcomes or changing outcomes in the middle of the trial. In the case of the TOGETHER trial, the potential risk of bias is in the opposite direction — i.e. achieving an unfavorable outcome. This can be done by, say, setting unrealistic magnitudes of benefit, stopping the trial early, using easily recognizable placebos so people can tell the difference or giving inadequate or toxic doses. 

The Gates’ Foundation position on ivermectin is not exactly clear. Most organizations tied to the foundation have largely taken an antagonistic stance to the drug — at least in its current off-patent form. GAVI, for example, recently published an article titled “Ivermectin: Why a Potential COVID Treatment Isn’t Recommended”. The article includes the totally erroneous claim that the US National Institutes of Health (NIH) does not recommend the drug. As we’ve reported before, the NIH has taken a neutral stance on IVM, neither advocating for or against its use. This is the reason why it’s possible, albeit difficult, to get ivermectin prescribed for COVID in the US, unlike most other advanced Western economies.

In a curious twist, at the same time that GAVI is publishing articles cautioning governments and doctors against using ivermectin against COVID, the Bill & Melinda Gates Foundation is quietly funding work on an injectable form of the drug. The project, developed by French biotech company Medincell, was officially announced on April 6, 2020. That was just after lab researchers in Australia had discovered that a single treatment of ivermectin could deliver a 500-fold reduction in virus cell culture after just 48 hours.

Medincell had already been studying Ivermectin in the context of malaria. According to the company’s own press release, its program “aims at developing a long-acting injectable Ivermectin formulation for several months to protect people who are not infected with Covid-19 in order to break the virus chain of transmission. Such a tool could play a decisive role in the management of Covid-19 pandemic, by enabling many people around the world, especially those most exposed and at risk, to protect themselves.”

Since Medincell uses a long-acting injectable technology to deliver the drug, it will presumably hope to secure a patent on its finished product, despite the fact that ivermectin has been off-patent for years. In April this year, the company announced that its clinical trial had confirmed the safety of administering ivermectin against COVID. Yet health authorities around the world, including the Gates-funded WHO, continue to call for more data.

Conflicts of Interest

Another big trial into repurposed drugs, the so-called PRINCIPLE trial, is taking place at Oxford University, which developed the AZ vaccine. Once again, the conflicts of interest are glaring.

The University of Oxford is heavily invested in the immunotherapeutics products and vaccines being developed by Vaccitech, a spin-out from the university’s Jenner Institute. It has also received hundreds of millions of pounds of funding from the Bill & Melinda Gates Foundation, including a grant for the objective of maintaining two websites that provide data regarding substandard and falsified medicines. As NC reported a few months ago, the foundation was instrumental in dissuading Oxford University from donating the rights to its coronavirus vaccine to any drugmaker, which would have made the vaccine cheaper and more accessible in poorer countries.

In a letter to the lead investigators of the PRINCIPLE trial, the Front Line COVID-19 Critical Care Alliance (FLCCC), a group of widely published critical care physicians and scholars, and the British Ivermectin Recommendation Development Group (BIRD), a U.K. based group of medical and scientific experts from more than 16 countries, questioned the ethics of the trial, given that half of the participants who are suffering from COVID will receive NO treatment. Some could end up dying — completely unnecessarily, the letter says, given “the latest research shows beyond a doubt that ivermectin is an effective treatment for COVID-19 in all stages of the disease.”

The letter also raises serious concerns about the quality of data the trial is likely to produce:

The trial intends to observe the antiviral properties of ivermectin in patients that have been showing COVID-19 symptoms for up to 15 days. It is well known that the virus naturally clears the body in 5 to 7 days. Measuring antiviral properties of a treatment when the virus may have cleared the body naturally is unlikely to be useful for providing reliable evidence or clinical guidance.

One can only hope that the concerns raised by FLCCC and BIRD’s joint letter are unfounded, and that: a) nobody dies in the trial; and b) its processes are not rigged to ensure that the findings come out negative. Such an outcome would no doubt be reported massively and uncritically by the media. That could be enough to kill off all hopes of using the medicine against COVID — at least in its cheap off-patent form — not only in the countries that aren’t using it yet but even some of those that are. The result would be many more lives needlessly lost as well as the loss of one of the potentially most important lines of defence we have against this pandemic.

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  1. Eye 65

    After having a PC the past 25 years one thing I can say is that nobody would know more about viruses than Bill Gates.

  2. Mikel

    “The trial intends to observe the antiviral properties of ivermectin in patients that have been showing COVID-19 symptoms for up to 15 days. It is well known that the virus naturally clears the body in 5 to 7 days…”

    That’s the excerpt from a letter by medical and science professionals.

    No, it is not well-known. I keep hearing that the risks of “long covid” are one the reasons that experimental shot benefits outweigh the risks.

    So I read link for more context.

    “..It is well known that the virus naturally clears the body in 5 to 7 days. Measuring antiviral properties of a treatment when the virus may have cleared the body naturally is unlikely to be useful for providing reliable evidence or clinical guidance…”

    So, do these professionals think “long Covid” is not enough of a problem to be included in the trial? Because it seems to me that if they want to include people in the study that have been showing symptoms for up to 15 days, they would have to have people with those symptoms. It says “up to 15 days”, so the trial simply wouldn’t have many people in it showing symptoms after 5-7 days.

    I want the trials to be fair too, but is there more context for the statement:
    “It is well known that the virus naturally clears the body in 5 to 7 days…”

    That doesn’t sound like they are even describing a pandemic causing virus. Do scientists and health professionals even agree on what are considered long-term symptoms of the virus?

    What are being considered “symptoms” ? People laying in bed for weeks with trouble breathing (shown on tv over and over again)
    aren’t showing symptoms?

    1. Nick Corbishley Post author


      I think there’s a bit of a misunderstanding here. I think what the writers of the letter are trying to say is that the first phase of the illness, the viral phase, does not normally last much longer than five to seven days. That’s why many people are no longer contagious in their second week of symptoms. That doesn’t mean that the illness is now over, just that it has moved on to the next stage: the inflammatory phase, which is when the real damage begins to take place. As such, trying to measure for the anti-viral properties of a medicine when the viral phase is all but over is likely to produce pretty unimpressive results.

      Plus, as with any illness, the sooner you treat a patient, the better chances you have of achieving a positive outcome. This is as true of ivermectin as it is of most other medicines. While some trials have suggested IVM has a pretty robust effect during the inflammatory phase (7+ days), it is not as impressive as during the viral phase. Plus, it needs to be administered alongside other medicines such as corticosteroids.

      1. Societal Illusions

        I’ve noticed a consistent theme from those advocating taking these existing off-label drugs to reduce covid hospitalization and mortality: taking them early in the infection.

        And testing against long covid would be a different study, wouldn’t it, involving a different participants?

        I find this statement COMPLETELY disingenuous given the documented amounts of money governments around the world have provided vaccine research: “After all, who is willing to invest millions of dollars testing a drug that is likely to generate little, if any, financial return?”

        This entire subject continues to disgust me, and if it and the narrow focus on a vaccine “solution” doesn’t confirm the ongoing corporate capture and non-scientific biases of government, education and media, I don’t know what more is required to demonstrate that the true objective had NEVER been public health and safety.

        1. Skip Intro

          And this is reminiscent of the common straw man claiming IVM didn’t help severely ill patients, when its use for prophylaxis and early treatments are the most important and interesting claims.

      2. Jeri Vincent

        I have a few questions:
        1. How do you pinpoint “the viral stage” if one may be asymptomatic prior to testing positive for Covid?
        2. Does the active or viral phase begin when one tests positive for Covid with or without symptoms?

        1. Nick Corbishley Post author

          Hope this helps, Jeri, from the website

          It seems that infectiousness is highest in the one to two days before symptoms start (coinciding with a high rate of presymptomatic transmission), and that seven days after symptom onset there is very little chance that infections will be transmitted…

          The median incubation period, the time between infection and the onset of symptoms, is 5.2 days, but it can be as long as 14 days in some cases.

          If a patient remains asymptomatic 14 days after exposure, the patient is unlikely to develop symptoms. This is why people have been told to self-isolate or quarantine for 14 days.

          1. Mikel

            “The median incubation period, the time between infection and the onset of symptoms, is 5.2 days, but it can be as long as 14 days in some cases.”

            The article said:
            “It is well known that the virus naturally clears the body in 5 to 7 days…”

            So the viral stage hasn’t been exactly pinpointed.

    2. Dwight

      The point is early treatment in the viral replication stage to keep people from getting Covid, short & severe or long & debilitating.

    1. Lambert Strether

      We have repeatedly requested that readers not dump YouTube links in comments without giving readers a summary, so they can determine whether or not to click through. Not everyone has an hour to spend watching a video to find out whatever the point you think the video makes might be.

      And yet, here is your comment.’

      No more like this, please!

    1. Shonde

      I just now clicked the provided link and discovered the account has been terminated so that makes it even more important that a summary be provided so readers can determine whether it might be worthwhile looking for the material elsewhere.

  3. Adrian D.

    ICYMI: The Bryant et al study was criticised on the BBC’s ‘More Or Less’ programme (on the World Service). They essentially rubbished the Bryant et al. meta-analysis, but did so in a pretty transparent way (clips to Donald Trump’s HCQ comments etc.). They failed to contact Bryant or Tess Lawrie prior to broadcast, instead using an Australian epidemiologist Gideon Meyerowitz-Katz who tweets as @GidMK as the Health Nerd. He did some stats that he said pretty much debunked it, but in doing so managed to conflate various aspects of terminology & statistical practice in a manner that tended to minimise the potential for ivermectin. He gave equal weight to another meta-study that find a significant effect of ivermectin, but failed to note the numerous problems in that study despite pointing similar alleged ones in the Bryant one.

    All rather par for the course in the MSM & off-patent drugs.

    You can listen to the programme here:

    And see Lawrie’s response here:

    1. Adrian D.

      ICYMI2: There’s another recent analysis of the studies in the Bryant et al metastudy, which directly compares it to the ‘no effect’ Roman et al metastudy (raised in the BBC programme). It’s strongly supportive of ivermectin from these trials using a Baysian rather than ‘classical’ approach. Very much worth a read for the stats if nothing else:

      And finally this rather scathing review of the Roman et al meta-study that found no effect of ivermectin:

      Enjoy! And keep it un Nick.

  4. Edward Hackett

    I agree that big money is behind much of what is happening in the world today. My question is, “Who will fund the drug trials if not big pharma?” What organization has the capital to invest in trials from which they will derive no benefit?
    My other thought concerns the actions of rich, predominately white countries as they talk about helping other less wealthy countries. Based upon past and present actions, it would appear that the wealthier countries only care about other, less wealthy countries if there is a mineral or other product to be exploited.
    In fact, the wealthy in the wealthier countries don’t really care about their own less wealthy citizens, let alone the citizens of other countries, when there is no economic benefit to be derived.
    To quote the sentiments voiced by DJT, “Who cares about the unwashed in their s**thole countries?” I dislike saying anything positive about him, but it would seem that he is basically correct this time.

    1. Yeti1958

      In Canada funding apparently is provided by Health Canada upon request by any accredited person, ie a doctor. I filed an adverse reaction report on IVM saying that the adverse reaction is that it cures Covid-19. I was called by Health Canada and told the above information. I asked if there were any requests to study IVM put to them and was told they only report on accepted studies. I asked if any requests to study IVM had been denied and was told they could not comment on that. Next on line is a FOI request to Health Canada. It is my belief that only when and if this pandemic is over we find the truth about IVM.

      1. Maritimer

        Here are some good questions for Health Canada:
        Has Ivermectin been used at all to treat Covid in CDN hospitals?
        If so, under what circumstances?
        Have any CDN Doctors or Health officials or their families received Ivermectin to treat Covid?

        CND Doctors, Health officials, politicians and many other bureaucrats have themselves and their families, friends to worry about and get treated properly. There certainly must be some CDN Docs in the system who are going to use alternative treatments.

        Just think about the possibility of a CDN Doc treating family, friends, influencers with Ivermectin while denying it to a regular patient. Malpractice? Malfeasance? Criminal negligence?

        I can imagine the tort lawyers compiling their deposition questions now.

        1. Yeti1958

          I have a prescription for a 5 day course of ivermectin as recommended by the FLCCC in case I contract Covid-19 yet cannot have it filled due to the fact that Merck has restricted access to it in Canada. Who is running our health care system?

    2. d w

      well he is purported to be a billionaire right, there is some question about that? so its no surprise that he doesnt care much about any one who isnt a billionaire. course he might have other tendencies, like as long as you get what he wants, your golden, fail at that, and you are toast. and since those in the sub millionaire arent important (unless they will contribute to his PAC, or buy what ever he is selling). no matter where they live

  5. flora

    There’s only one potential problem: where it gets its money.

    Indeed. “He who pays the piper calls the tune…” or something like that. (Shouldn’t be that way in medical research, but more and more it appears it is that way where large sums of money are involved.)

    1. ambrit

      I’ll chime in here with the observation that “moderne” medicine has disconnected from the “Public Good,” at least in America, and firmly allied itself with various “Private Goods.” So, if the Public were the ultimate source of funding, shouldn’t all the rest follow ‘organically?’ (One of a series of arguments in favour of establishing an American National Health System.)

      1. Societal Illusions

        Isn’t the core assumption underlying your suggestion that those responsible for the “Public Good,” whether elected or appointed, are inherently honest, transparent, and seeking to fulfill their duties with integrity?

        Without this…

        1. d w

          well there is hope that they might be.

          from current results, you cant expect or hope that private companies will ever do that. they have only 1 real purpose

          get your money

    2. Kris Alman

      It is irrelevant that public dollars finance the majority of most drugs approved by the FDA.

      Substitute Covid-19 for hepatitis C.

      “The problem occurs when you get a very large disease class like hepatitis C. Should the argument then reverse — i.e., that the price has to be lower because it’s a very high volume of people? Generally we do not adjust prices in a market-based system based on the number of consumers. Price is more related to value.” In the U.S., Danzon adds, value is often defined as whatever price the market will bear.

      Drug R&D relates to PhRMA defined “value” which is related to neoliberal values.

      1. flora

        Public dollars are distributed by electeds and appointeds who, these days, seem more like go betweens for their private payers (their biggest donors) and public dollars distribution decisions. Neoliberal values indeed. Mark Twain quipped “we have the finest Congress money can buy.”

        1. d w

          maybe have an unelected group, of doctors, nurses, pharmacists, general public, drive investment? be sort of what the post office used to be, back when it worked, as opposed to now

          also divide up the group be appointed by different groups, who have to agree on approvals

          might think it would take while to get approvals huh? only if drugs arent new can only be approved by a majority. and the drugs are in sequence, first come first serve, unless there is an emergency

          1. flora

            fractalism all the way down…. only “changing the equaton” changes the outcome. Mandelbrot understood. Changing “the equaton” is what real populism (not some rightwing huffing) is all about, (see Tom Frank’s new book). Otherwise, it’s only rearranging the deck chairs…

  6. Kris Alman

    In 2014, I was working with a coalition in Portland, OR on access to essential medicines. The poster drug at the time was Solvaldi. I took a deep dive and attended the Global Health Law Summer Institute held by the University of Washington Department of Global Health.

    Location: William H. Gates Hall of the UW School of Law.

    Need I say more? Gates’ sycophants licking their chops for $$$.

    Return on Investment or Rest in Peace. That’s how Scott David (who was at that time the Executive Director of Law, Technology and Arts Group at the University of Washington) framed the problem for the panel discussion on “The Access Challenge,” which included a patent attorney.

    I wrote about this at the Lund Report.

    So quaint the days when the patent attorney and their financiers applied this equation for drug pricing:

    Price at Market Entry = [(Cost Factors X Profit Margin)] + Projected Sales + Amortization Period
    Amortization Period = Regulatory Exclusivity or Patent Exclusivity

    Solvaldi merited an investigation by the Senate Finance Committee, which yielded the tricks of the “what the market will bear” trade. Sovaldi’s $1000 blockbuster drug was a boon for Gilead Sciences shareholders and executives, who created a tide for “shadow drugs” to ride the wave, rather than create a competitive market.

    It’s Return on Investment and Rest in Peace when it comes to drugs like remdesivir in the treatment of Covid. Or the controversial Alzheimers drug, Aduhelm. (Like Adulem, the FDA accelerated Sovaldi’s approval through a new “breakthrough therapy” designation for treatments of life threatening illnesses.)

    It goes without saying that every session I attended at the Global Health Law Summer Institute spun the story of do-gooder American capitalists who innovate, create jobs, give aid to developing countries, promote democracy and do absolutely no harm.

    Having just gotten my kids through k-12 public education, I had already ingested near lethal doses of Gates’ corporate education reforms in my activism. After that 2014 experience, I concluded his neoliberal ways were bankrupting the world.

  7. Richard Needleman

    I don’t know whether this violates the naked capitalism guidelines, but for those who do not have the time to read the interview with Dr. E. Mills referenced in this post, allow me to quote it so you can get the flavor:

    “I’ll wait for our clinical trial before I would make that recommendation. That particular group who authored that article have a well understood agenda promoting ivermectin, and no amount of evidence is likely to change their mind — whether that be favorable or negative evidence — I don’t think it’s going to change their mind. So one of the problems with the ivermectin topic is that the advocate groups around ivermectin have overcalled the importance of this drug. You can’t go around promoting a drug, calling it a miracle drug that will end the pandemic, when you don’t even have a good clinical trial to support it, and that’s exactly what they did. If indeed this drug has a treatment effect — and I am very optimistic that it will — it will just be one component of the interventions that we need.”

    “Here’s the thing: The people who wrote that article [in the American Journal of Therapeutics] claimed that this drug [ivermectin] is a miracle drug that has an effect of about 75% of reducing mortality. That is not far off the effect of a parachute when you jump out of a plane. It would not take much of a clinical trial to know whether that was true or not, and almost every physician would be able to spot really quickly whether there was a drug that miraculously was helping people. But we’re not getting that feedback from physicians and every decent clinical trial that is done on it concludes that there might be a treatment benefit, but it’s not obvious. Whether the drug has an important treatment effect or not, it’s just not going to be as large as what they claim”

    “In the Journal of the American Medical Association (JAMA). There is a rule of thumb in science — what they call the impact factor of a journal determines how important the journal. So if you publish in The Lancet, it’s got a very high impact factor, it’s usually very important. It’s a sign of good science to publish in a journal with a high impact factor. The one that you mentioned, the American Journal of Therapeutics, it’s not a serious journal.”

    “I know that paper very well because it’s been promoted as being some sort of big deal, but it’s not a big deal. Publishing papers is easy. Doing good science is very challenging. So I don’t have great respect for that. But that group is actually making it much more difficult to make the science be believed because they’re overcalling the importance of what they’re doing. They should just leave the science to the scientists and allow the clinical trials to complete.”

    Unmitigated nastiness (bordering on slander), arrogance, and pomposity. E. Mills obviously believes it is an imposition to evaluate the paper published in the inferior journal, “American Journal of Therapeutics” with a detailed critique. The data is supposed to speak for itself, not the character of the authors.

    The fact that the high impact Lancet and JMA published two of the worst papers I have ever seen—though they did have the advantage that they furthered the anti-IVM agenda of Pharma—seems not to worry him. As a side note, I published only two papers out of many in a low impact journal. However, they have still been cited a few hundred times, which is quite a respectable number, so they seem to be useful for some. Should I be embarrassed?

    From his comments alone I would not expect much; he has prejudged IVM already and in the crudest terms.

    1. KLG

      Aside from his nastiness, it is clear that Dr. E. Mills has no clue about “impact factor.” For which Eugene Garfield should still be in purgatory.

      Yes, The Lancet has a high impact factor. The Lancet also loosed Dr. (sic) Andrew Wakefield on the world, to who knows how much misery, morbidity, and mortality.

    2. Skip Intro

      every physician would be able to spot really quickly whether there was a drug that miraculously was helping people. But we’re not getting that feedback from physicians

      Sounds like a circular argument. How would docs see an effect if they were not advised that they should use it?

      1. SteveB

        Not only advised not to use…..
        My friend is a DR in NJ.. He received a letter from Trenton stating he would LOSE his license to practice if he prescribed IVM

      2. Obkective Ace

        And not just “not advised to use it”, but actively advised and in some cases threatened to “not use it”. The doctors going against the grain are saying exactly what Mill posits. They spot very quickly that there is a drug miraculously helping people.

    3. Mantid

      Richard, Thanks for the posted text. It’s pretty obvious that Dr. Mills is fairly biased. He says “no amount of evidence is likely to change their mind “. Well, there is no strongly negative evidence against IVM yet so of course one’s mind should be made up when a preponderance of the evidence is positive. And there’s a large quantity of that positive evidence. If Dr. Mills knows of massive studies that show IVM in a negative light, he should present them. However, he can’t because they don’t exist. Until he presents his supposed negative studies people, many people will die.

      Then “The people who wrote that article [in the American Journal of Therapeutics] claimed that … [ivermectin] … has an effect of about 75% of reducing mortality.” No, not one bit. They don’t claim anything. They present evidence that Ivermectin reduces mortality 75%. I’m not a math major but it’s not complicated. 75% positivity rate is pretty darn good. If my checking account earned 75%, over many months and years (aka many studies) I would not wait for further studies.

      The way Dr. Mills presents the question is quite biased against the facts. Sad.

        1. Richard Needleman

          My post was written too hastily due to my extreme distaste for his personal attacks. Next time I will try to add more substance and consider the meaning of impact factors and their lack of correlation with good science. The medical journals get their revenue from advertising and publishing in the Lancet, BMJ, AJM, etc. Publication is required for advertising new profitable treatments to their doctor audience. I don’t want to follow Mills and denigrate physicians, but it is accurate to say that they are generally not scientists (unlike Bryant et al.) and are necessarily highly dependent upon what they skim—not read—from article headlines. They are neither trained nor do they have the time required to evaluate basic science. Their scientific training in Med. School is at the level of a Scientific American article with the rest of the curriculum filled with memorizing information they will probably never need. The real training takes place after graduation.

          I knew a physician scientist at MIT, Alex Rich MD Ph.D , who discovered polyribosomes. While primarily a basic scientist he still saw patients. When asked whether his knowledge of basic science helped him in medicine, he said “Richard, I never had a patient who came in to tell me his ribosomes hurt.” As my wife would say, “There you have it”. I take care of the science and get my medical advice from the smart clinicians I trust…

  8. .Tom

    > The problem is that large randomised trials are prohibitively expensive, costing millions of dollars to conduct.

    I don’t think that’s really the problem. A pharmaco isn’t likely to pursue that but it’s small money for a lot of other interested parties including governments, some charities, and billionaires that want public adulation.

    I think the problem is the EUAs.

    1. Richard Needleman

      This assumes that the Bill Gates of the world do not have other financial interests. Bill is making his money from vaccines and preventing their access to third world countries. E. Mills and McMaster University, are heavily in debt to the Gates Foundation, one more reason not to trust them to evaluate IVM.

      He is funding the McMaster study. Any guesses why? And why would Oxford do an expensive IVM study while wishing to privilege AstraZeneca vaccine over treatments?

  9. KiWeTO

    A twist in this tale?

    Huge study supporting ivermectin as Covid treatment withdrawn over ethical concerns
    The preprint endorsing ivermectin as a coronavirus therapy has been widely cited, but independent researchers find glaring discrepancies in the data (Melissa Davey,

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