A timeline of ivermectin-related events in the COVID-19 pandemic

Background Ivermectin is a multifaceted medication invented in Japan in 1975 by professor Satoshi Ōmura, for which he won the 2015 Nobel Prize in medicine. Several billion doses of ivermectin have been administered since 1981. Currently, ivermectin preparations are available off-patent from many sources, with the production cost of a single dose estimated to be less than 0.1 US dollars. Review The interest in ivermectin with regard to COVID-19 was initiated by an Australian in vitro study published on April 3, 2020, indicating that a single treatment with ivermectin effectively eliminated the SARS-CoV-2 virus in cell culture. A few days later, two doctors in Peru begun treating a COVID-19 outbreak in a prison with ivermectin, later also treating the local police. In the second and third quarter of 2020 the use of ivermectin spread to other South and Central American countries, Egypt, India and Bangladesh, and later to Lebanon, Southern Africa and Southeastern Europe, with Slovakia being the first European Union country to adopt it. Ivermectin treatments raised controversy in many European Union countries and the United States which ignored ivermectin, referring to a lack of evidence of its efficacy and safety and demanding large-scale clinical trials. The World Health Organization (WHO) and the European Medicine Agency (EMA) advised against using ivermectin even after results of 26 randomized clinical trials were available in March 2021. In contrast, many developing countries adopted ivermectin with little evidence. In the United States, government funding was allocated to the development of a novel pharmaceutical estimated to possess an efficacy comparable to ivermectin but priced several magnitudes higher. Social media companies censored ivermectin researchers and research, with for example YouTube censoring results of a meta-analysis commissioned by the WHO. Traditional media appeared to either ignore ivermectin or publish negative commentaries only. Conclusion There was widespread disagreement on the fundamentals: which methods were appropriate as a basis for decision making, what counted as evidence, and what was ethical. Societies appeared disorganized, unable to transcend their current practices, financial structures and mindsets even when facing an obvious failure.