Steps to Curb Spread of Misinformation through Social Media and Closed Messaging Systems on COVID-19 Treatments

Mr Lim Biow Chuan asked the Minister for Health whether he can provide an update on the progress of the Government’s intended purchase of an anti-viral drug to treat COVID-19.

Singapore has been closely tracking the progress of COVID-19 therapeutic options under development globally, and actively engaging key pharmaceutical companies. As a result, we have procured in advance a portfolio of COVID-19 therapeutics.

Our current treatment options consist of five classes of drugs: Steroids, Anti-virals (Remdesivir), Monoclonal Antibodies (Sotrovimab and Regeneron), IL-6 inhibitors (Tocilizumab) and JAK inhibitors (Baricitinib). The use of these drugs is guided by the Treatment Guidelines for COVID-19 published by National Centre for Infectious Diseases and Chapter of Infectious Disease Physicians, College of Physicians, Singapore.

MOH recently signed an agreement with MSD Pharma (Singapore) Pte Ltd to purchase Molnupiravir, an oral anti-viral for treating COVID-19 patients. Molnupiravir will be available for use if MSD submits its data to the Health Sciences Authority (HSA) and obtains authorisation for use in Singapore. The timeline for approval is dependent on the company’s submission of data to HSA.

Doctors are allowed to prescribe drugs on an off-label basis if it is in the patient’s best interest, there is sufficient clinical evidence to suggest clinical benefit to using the drug, the patient has an appropriate and justifiable medical indication, the benefits of such use have been assessed to overcome the risks associated with the medication, and the patient’s informed consent for such use has been obtained. These principles are part of the Singapore Medical Council’s Ethical Code and Ethical Guidelines.

All prescription medicines require approval by HSA before they can be legally supplied in Singapore. Companies licensed to import or distribute prescription medicines are regularly audited by HSA. This is to ensure their compliance to the regulations and international standards and minimise the risk of illegal supplies.

HSA works closely with the Immigration & Checkpoints Authority to monitor and stop illegal imports of health products, including prescription medicine such as ivermectin and hydroxychloroquine that are brought in by unlicensed importers. HSA conducts regular joint operations with local enforcement counterparts at hotspots. With the rise of e-commerce, HSA also monitors various local online sales platforms to detect illegal sales of prescription medicines. HSA takes a serious view against those engaged in the illegal import, sale and supply of these products, and will take strong enforcement action against such persons. Anyone who contravenes this law can be fined up to $50,000 and/or jailed for up to two years under the Health Products Act.

MOH is aware of misinformation on websites and social media platforms, including online chatgroups, on the safety and effectiveness of ivermectin in treating COVID-19. The misinformation is based on unverified studies. MOH and HSA have put up consumer advisories on their websites and issued media statements to debunk misinformation on COVID-19 treatments. For example, MOH has clarified on its website that evidence to date suggests the use of these agents is associated with serious risks to the health of the patient. On 15 October, MOH also issued a media statement to call out these websites and platforms and to counter the misinformation found there. On 24 October, a Correction Direction order was issued to the Truth Warriors website for false statements of fact and misleading information it had published. Clarifications and facts have also been published by the Government.

Ivermectin is a prescription-only medicine for the treatment of parasitic worm infections. It is not approved by HSA for use in the prevention or treatment of COVID-19. HSA has advised against self-medicating with ivermectin and to consult a doctor for the proper treatment of COVID-19.

The Pharmaceutical Society of Singapore has been publishing consumer advisories on their website. The public can also approach healthcare professionals, such as community pharmacists, to find out more about these medications.