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Africa has remained remarkably Covid-free, much to the puzzlement of Western experts. Several factors appear to be at play, but one that cannot be ignored is the continent’s widespread use of the anti-viral drug Ivermectin.

Africa, the world’s second largest continent, has remained mostly unscathed by the pandemic since the beginning of 2020. Last week, the Associated Press reported that experts, who feared that Covid-19 would sweep across Africa and kill millions, are unsure why the continent has fared so well.

While the Americas account for 46% of the global Covid-19 death toll, and Europe represents 29% of the total, Africa has sustained only 3% of worldwide coronavirus deaths.

Obtaining accurate Covid-19 data is a challenge for African countries. Nevertheless, the AP reports that experts are surprised at the figures they do have access to. Wafaa El-Sadr is the chair of global health at Columbia University. She told the outlet,

Africa doesn’t have the vaccines and the resources to fight Covid-19 that they have in Europe and the U.S., but somehow they seem to be doing better.

The World Health Organisation has described Africa as “one of the least affected regions in the world” even though less than 6% of its population is vaccinated.

Reasons For Africa’s Success

Several factors may help explain the anomaly in Africa. The average age of the continent’s population is more than two decades younger than Western Europe’s, where the elderly have been especially hard hit by the virus.

Africa is also less urbanised, which may have helped slow the spread of Covid-19. Additionally, Africans tend to spend more time outdoors — something that many Western governments ironically discouraged over much of the past two years.

Additionally, the AP reports that studies are underway to ascertain whether Africans have stronger genetic protection against Covid-19, or whether past infection with diseases such as malaria may be a factor.

Cultural values may also be at play. According to Devi Sridhar, chair of global public health at the University of Edinburgh, “there’s a different cultural approach in Africa, where these countries have approached Covid with a sense of humility because they’ve experienced things like Ebola, polio and malaria.”

South Africa has lost some 89,000 people to Covid-19, making it one major exception to Africa’s success.

The Role of Ivermectin

One factor not explored in the Associated Press report is the anti-parasitic drug Ivermectin. A study conducted in December 2020 explored the potential role of Ivermectin in Africa’s success against the virus during the first year of the outbreak.

Titled COVID-19: The Ivermectin African Enigma, the Colombia médica study compared the Covid-19 statistics of two sets of African countries. The first group, comprised of 19 nations, participated in a WHO-sponsored Ivermectin mass campaign aimed at combatting river blindness. The second group was made up of 35 nations that did not partake in the campaign, one of which was South Africa.

After controlling for different factors, the study found that the nations with prevalent Ivermectin use showed 28% lower Covid-19 mortality and 8% lower infection rates.

In the developing world, Ivermectin has been used prophylactically with considerable success, despite repeated denunciations of the Nobel-prize winning drug in Western media. In Australia, the drug has been banned by the TGA for the treatment of Covid-19.

While noting that additional research is needed to confirm their findings, the authors of the Colombia médica study called the role of Ivermectin in Africa’s Covid-19 success an “attractive hypothesis”.

Ivermectin’s patent ran out in the 1990s, meaning that it is no longer able to generate significant profits for governments or pharmaceutical companies. It costs around 12 cents per tablet to produce, which has made it an affordable solution for broad swathes of the developing world.

This month, Pfizer released a new antiviral drug called Paxlovid which is chemically novel but that has a modality of action identical to that of Ivermectin. Paxlovid has a price tag of US$529 per course.

Image by Annie Spratt on Unsplash.