Ministry of Health & Wellness Intranet

Port of Spain, Trinidad and Tobago. 18 May 2021. The Caribbean Public Health Agency
(CARPHA) is urging Ministries of Health and clinicians to only use the medicine, ivermectin, under
the conditions of well-regulated clinical trials for COVID-19, or for approved indications. This is a
result of the limited evidence available to assure a favorable benefit-risk balance when used in
treating patients with COVID-19. This is also reflected by the recommendations of the global health
authority, World Health Organization (WHO).

In its “Therapeutics and COVID-19: Living Guideline”, March 31, 2021, the WHO Guideline
Development Group explains “The effects of ivermectin on mortality, mechanical ventilation, hospital
admission, duration of hospitalization and viral clearance remain uncertain because of very low
certainty of evidence addressing each of these outcomes.” The WHO in its press release on
ivermectin also noted that the current evidence is of “very low certainty,” due to the small sizes and
methodological limitations of available trial data.

In light of this, Executive Director, CARPHA, Dr. Joy St. John says “I am aware that some countries
have already begun to use ivermectin in the treatment of COVID-19, and others may be considering
using the drug as a possible treatment. However, CARPHA is urging our Member States to heed
the current advice of the WHO, regardless of disease severity or duration of symptoms.”
The Pan American Health Organization (PAHO) “Living Update of COVID-19 Therapeutic Options
Rapid Review” of May 6, 2021 notes that after review of 28 clinical trials “New evidence from
randomized clinical trials was evaluated, however there is no change to the assessment that the
medicine does not significantly reduce mortality and probably does not improve time to symptom
resolution.”

Also recognizing the need for further research, the US National Institutes of Health (NIH) states
“Results from adequately powered, well-designed, and well-conducted clinical trials are needed to
provide more specific, evidence-based guidance on the role of ivermectin in the treatment of COVID-
19”. According to the NIH, ivermectin is an antiparasitic drug that is used to treat several neglected
tropical diseases, including scabies. Furthermore, ivermectin is not approved by the US Food and
Drug Administration (FDA) for the treatment of any viral infection.

CARPHA does not support the use of ivermectin outside of appropriately designed, well-regulated
clinical trials for the treatment of COVID-19. Further CARPHA maintains that large randomised
controlled clinical trials, with robust study design, meaningful endpoints, and significant results are
essential to inform public health decision-making about treatments for COVID-19, as these are
designed to rule out findings of benefits and risks that may appear due to chance.

More information about CARPHA’s Regional Response to the COVID-19 Pandemic