How did this under-resourced country send Covid-19 packing?

Clue: it wasn't due to the vaccines and certainly not because of the WHO

Back in April, a colleague sent me an intriguing message from Dr Tarek Alam, Departmental Head of Medicine at Bangladesh Medical College in Dhaka. In this message, Dr Alam pointed out the Covid-19 mortality rate in Bangladesh has been lower than India’s in all three waves. Significantly lower.

In the last two years, India has suffered over 500,000 Covid-19 deaths, or 373 deaths per million. That’s still relatively low compared to the UK for example, which has had 2,607 deaths per million, or the US which has the highest number at 3,088 deaths per million. However, Bangladesh has suffered just 29,000 deaths from Covid-19, or 174 deaths per million. In other words, Bangladesh’s death rate from Covid-19 is less than half that of India’s.

Dr Alam then posed the essential question: why?

He wrote:

“In a country like Bangladesh with resources less than India, Italy, UK, USA, what could have been the cause that prevented the calamity of delta, omicron? The race and genes [in Bangladesh] are same as the Indian population, who just across the border stood and died in lines for admission in hospitals. The vaccination rate was lower during that time in comparison to the UK and USA. Also, the mask-wearing rate by most Bangladeshis was [enviably low] compared to the rest of the developed world.”

Dr Alam has his own theory, best explained by going back to the very beginning of the pandemic in Bangladesh.

In the early months of 2020, Dr Alam was treating Covid-19 with azithromycin and hydroxychloroquine, a standard treatment approach at the time. However, one day at the end of April, an oncologist came to see him with Covid-19. She explained that she could not and would not take azithromycin or hydroxychloroquine because of cardiac issues, so would need an alternative treatment. Fortunately, Dr Alam had by then read a research paper showing that ivermectin inhibits replication of SARS-CoV-2. He decided to prescribe ivermectin along with doxycycline. Ten days later when he followed up, he was amazed to learn that she had recovered within just seven days.

He described this moment as ‘eye-opening’.

Very soon after, he prescribed the same treatment again. At that point, like many countries, Bangladesh was heading into full lockdown and many overseas students were being evacuated. A handful of students, however, tested positive for Covid-19, leaving them stranded. With the hospital’s permission, Dr Alam prescribed each student a single dose of ivermectin with doxycycline. This time, recovery took just four days for most, five days tops.

Dr Alam began to spread the word. The nation’s media picked up the story, sharing his message that ivermectin is a cheap, effective alternative to hydroxychloroquine. Across the country, doctors, paramedics and pharmacies began to prescribe ivermectin for treating and preventing Covid-19. Some senior doctors were reluctant to use it as it wasn’t FDA approved, but as Dr Alam explained, ‘we didn’t have anything to lose.’ Since ivermectin was already available over the counter for treating scabies and head lice, it was already well known to be a safe medicine.

In the following two years, Dr Alam personally treated around 2,000 people with ivermectin in combination with doxycycline, vitamin D and zinc. Ivermectin became standard treatment within the police and armed forces, where it was also used as a prophylactic. In fact, it became so widely used, that the country experienced shortages and the price of ivermectin increased from 5 taka (5 cents) to as much as 200 taka ($2.24) on the black market.

While wealthy, developed countries like Australia, the UK and USA have experienced mass hospitalisations and deaths, under-resourced Bangladesh has held its own against the disease. It’s not just that the country had fewer deaths, but also that it had fewer hospitalisations: people were treated with ivermectin in their own homes, so few ever actually needed hospital treatment.

In Dr Alam’s mind, ivermectin is so far the most likely explanation for his country’s low Covid-19 mortality rate. “Maybe someday, somebody will give a proper explanation of why we didn't get infected or die like the rest of the world” he writes. “Until then, we Bangladeshis would like to believe it was God's Grace in the form of ivermectin.”

I wanted to share Dr Alam’s encouraging story for two reasons. First, to emphasise once again that when it comes to Covid-19, ivermectin saves lives. But I also want to celebrate Dr Alam and his country’s response, which was to at least try this proven safe and cheap medicine to treat a novel disease in a global pandemic. He had the support of his government, who issued guidelines accepting ivermectin as an experimental medicine. He also had the support of the media, who helped to get his message out. As many of you will know, getting the press to report accurately on ivermectin has been impossible in many countries, including here in the UK.

I asked Dr Alam whether the WHO had been in touch with him at all to find out more about his results. Yes, they had, he said. In fact, WHO India approached him back in May 2020 when Dr Alam first started sharing about ivermectin.

Did WHO India want to hear more about his results so they could share them with other nations in need? Not exactly. Rather, they asked him to halt his treatments and run a randomised controlled trial first, before prescribing ivermectin.

It beggars belief, doesn’t it? And yet, this is typical of the WHO’s response in this pandemic. How can the WHO justify waiting for more RCTs before treating people with a drug it knows is safe, and could in fact save lives? It takes me back to Andrew Hill and his paper that concluded more RCTs were needed before ivermectin could be recommended for treating Covid-19. As many of you know, he admitted that he had been pressured by his sponsors to alter his conclusion, despite the data clearly demonstrating that ivermectin limited infection and reduced mortality. In my opinion, Dr Hill’s terrible compromise has led to millions of lives being lost as a result of being denied ivermectin.

Every person treated by Dr Alam should be grateful that he ignored the WHO’s request for RCTs and prescribed ivermectin anyway. Thank goodness he and all the other medical professionals in Bangladesh did so – and I wish that other nations could have been as sensible.

Update on the WHO’s IHR amendments and pandemic treaty

Dr Alam’s story is yet another damning example of why the WHO is the last organisation anyone would want dictating public health policy. Despite withdrawing all but one of the proposed amendments to the International Health Regulations, the WHO’s attempted power grab continues.

I’ve written about this extensively already, but I want to bring your attention to a recent press conference held in Geneva by the International Alliance for Justice and Democracy (IAJD). In particular, to the presentation made within that conference by World Council for Health Steering Committee member Shabnam Palesa Mohammed. She starts at 26:30 minutes in and offers a concise and damning explanation of why the WHO is utterly compromised by conflicts of interest that have ultimately led to crimes against humanity.

Please do take the time to watch Shabnam, and share far and wide. It’s as clear an explanation as any as to why we need to #StoptheWHO.

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