A Sad and Shameful Day for Australian Medicine

A Sad and Shameful Day for Australian Medicine. By Robert Clancy, Emeritus Professor of Pathology at the University of Newcastle Medical School. He is a member of the Australian Academy of Science’s COVID-19 Expert Database.

September 10, 2021, was a black day, the day a group of faceless bureaucrats known as the “Advisory Committee for Medicines Scheduling”, through its effector arm, the Therapeutic Goods Administration (TGA), compromised medical practise and the health of their fellow Australians.

The TGA used its regulatory muscle to prevent doctors at the COVID-19 pandemic’s coalface from prescribing ivermectin (IVM), the one therapy available that is safe, cheap and which reduces mortality in the order of 60 per cent. …

Works in India, but not in Australia

The immediate consequence of the TGA Notice means patients contracting COVID-19 are left to hear, “Sorry, no treatment for COVID-19 is legally available. Just go to hospital when you get very sick.”

In the longer term it means that bureaucrats can change the way medicine is practised for whatever reason without review by, or discussion with, the medical community. …

The evidence that IVM is safe and effective in both preventing and treating early (pre-hospital) COVID-19 is overwhelming … Despite this evidence, every artifice has been used to quash IVM’s use and to do so in unprecedented fashion. The causes for the suppression include political agendas, pressures from pharmaceutical companies, ideology and breakdown in medical communication. This latest blow by the TGA follows its previous form in shutting down use of hydroxychloroquine, another safe, effective and cheap COVID-19 therapy.

Every experienced doctor prescribes drugs for “off-label” indications. It is anathema and dangerous that the doctor-patient relationship can now be over-ridden by government agendas.

Dodgy “science” provided political cover:

The driving source of “evidence” that IVM has unproven therapeutic value is the Cochrane Review, which concluded from a single meta-analysis that the benefit in treating COVID-19 was “unproven”. This was out of line with a series of supportive meta-analyses by non-conflicted competent epidemiologists.

In science, you can’t just choose one extreme study from a range of studies and proclaim that study to be the truth. Unless there are some real good reasons, the other studies are equally valid. So which one is true? Never mind, the political types do their damage:

Yet results from Cochrane have singularly been adopted without criticism or discussion, initially by the National COVID Clinical Evidence Taskforce (NCCET), then by diffusion via various professional and regulatory bodies while being fanned by an even less critical mainstream press.

Thus IVM is seen by many, including some medical professionals, as the snake-oil of our age.

What is not discussed is the validity of the Cochrane Review and the advisory messages from the NCCET. The influence of vested interest parties on Cochrane has been previously raised. The circumstances of generating the review by an unknown German group when experienced epidemiologists were available needs explanation. More immediately, critiques of the Cochrane analysis and the NCCET by unaligned British epidemiologists show defective methodology, cherry-picked data and exclusion of a raft of supportive data.

The information source used to formulate policy in Australia is both out of kilter with conclusions from over 60 controlled clinical trials and the positive experience recorded when IVM was used in national and regional programmes. Cochrane is an incomplete and unreliable basis for decision making on COVID-19 management in an Australian context. The views of international experts are trumped by unknown local bureaucrats.

Surprisingly, the reasons given by the TGA for their decision on IVM are not the usual mantra of “unproven”, based on Cochrane, although that is left hanging as a “given”. The reasons are even less defensible: “supply may become limited” (incorrect, but this nevertheless demonstrates there is a need for the drug); “concerns re toxicity due to dosage determined by social media” (this concern is easily remedied by controlling usage through front-line doctors), and, lastly, the real reason: “It may interfere with the vaccination programme”. What an extraordinary statement!

The Australian Government did the same over the modeling of opening up to covid after 80% vaccination, anointing the Doherty Institute’s modeling as the one true vision. However, among the various models, Doherty’s was an outlier — on the optimistic side. Perhaps its assumptions were chosen to give the result the political authorities wanted, who knows? In any case, all the other modeling groups painted a less rosy picture.

Political types make a habit of choosing the result they want from a range of studies. No, it’s not a menu, but a range of estimates, all of which have to be taken into account. All studies, at least ostensibly, are an attempt to discern the truth. Remember, reality is what remains after believing goes away. The world of science disregards your beliefs and preferences.

hat-tip Stephen Neil