The myth of widespread Ivermectin use in Japan

Since this issue often comes up, I thought I’d do a Q&A post on it.

Is IVM a recognised anti-Covid medication in Japan?

Nope. The only three anti-virals the Japanese Ministry of Health, Labour, and Welfare (MHLW) has authorised for use to treat Covid are Gilead’s organ-damaging Remdesivir, Merck’s meritless Molnupiravir, and Pfizer’s blood-clotting Paxlovid (aka, nirmatrelvir/ritonavir). On other words, the MHLW copies the FDA when it comes to not only the jabs but also medications. The full list of approved medical products in English can be found here.

So why do some people think IVM is commonly used in Japan?

The confusion seems to stem from the head of the Tokyo Medical Association (TMA), Dr Haruo Ozaki, recommending IVM be authorised for treating Covid patients back in August 2021.

“Although an examination is necessary by conducting a clinical trial properly, under a strained situation like this, I think we’ve reached a stage where it’s OK to have the authorization issued to use ivermectin on patients after getting their informed consent,”

Well that authorisation never came, and Dr Ozaki hasn’t mentioned IVM since August 2021. Moreover, neither the TMA nor any other national or perfectural medical association has ever officially recommended IVM in any case. And because IVM isn’t an easily obtainable over-the-counter drug in Japan, people have resorted to importing it.

The truth is the authorities in Japan have been as uninterested in early treatment as authorities elsewhere. For instance, if you test positive and have to isolate at home in Tokyo, the Tokyo Metropolitan Government will send you the care package below. No vitamins or anti-virals, or anything particularly nutritious for that matter.

But Dr Ozaki’s brief flirtation with the idea of using IVM led to well-meaning early-treatment proponents misunderstanding the situation in Japan. You may have seen graphs like these showing how Covid cases and hospitalisations came down after Dr. Ozaki’s recommendation.

But this is the same post-hoc logic that Covidians tend to suffer from (“Japan had few deaths because they wear masks!”). By the same logic, the Tokyo Olympics can be credited with reducing Rt three weeks before Dr Ozaki mentioned IVM.

Infections rose in July and fell in August in Japan in 2020 too (hat-tip Ian Miller), so there really wasn’t much excuse for falling for the illusionary effect of Dr Ozaki’s recommendation in 2021.

So IVM isn’t used to treat Covid in Japan?

I didn’t say it isn’t used. It’s used by some doctors, but not widely. Japan’s most famous IVM proponent is probably Dr Kazuhiro Nagao (right), who even managed to get on TV around the time Dr Ozaki made his recommendation.

But Dr Nagao’s TV appearance advocating IVM was no more effective at getting the authorities and other medical professionals to adopt IVM than his later TV appearance discussing post-vaccine syndrome was at getting them to stop the jabs.

Japanese TV gently touches on post-vaccine injuries

Other Japanese medical professionals have published studies of IVM that showed favourable results…

…but so have medical professionals elsewhere. Without the government’s approval, IVM won’t be used outside of a few open-minded medical institutions. Dr Ozaki clearly understood this, which is why he explicitly mentioned getting authorisation before using it.

So the government doesn’t actively suppress IVM because it doesn’t have to. Most medical institutions in Japan will generally go along with whatever the MHLW and medical associations recommend, which is inevitably patented and profitable drugs.

Okay. So this meme isn’t true then?

Abe hadn’t been PM since August 2020, so whoever posted and shared that meme clearly didn’t follow Japanese politics closely. Even if he’d been in office, the other points are irrelevant: Japan constitutionally can’t mandate the Covid vaccines anyway; the 1.6 million doses were contaminated Moderna shots that were thrown away, not sent back; and neither Abe nor any other PM has given citizens IVM. Seriously, if you showed that meme to a Japanese person, they’d think you were talking about a different guy and a different country.

I’m still pretty sure Abe’s resignation in 2020 was due to his desire to relax Japan’s Covid response, but there’s no evidence he was a vaccine skeptic. Quite the opposite. Below is Abe speaking in January 2022.

“Caution towards Omicron is needed, but if drugs and vaccines can prevent severe disease, we have the option of treating Covid as a Level 5 infectious disease the same as seasonal influenza.”

One more thing. Does IVM actually work?

The overall evidence suggests it does.

But whether it works or not doesn’t matter to our friends at the MHLW. There just ain’t no money in it.