What does WHO recommend about ivermectin for COVID-19 treatment as of 2025?
Executive summary
The World Health Organization has not endorsed ivermectin as a standard treatment for COVID‑19 and, in guidance dating to 2021 and reiterated in later summaries, recommends against use of ivermectin for COVID‑19 except inside clinical trials because evidence of benefit is very low or insufficient [1] [2]. Major health agencies including the FDA and NIH likewise do not approve or recommend ivermectin for COVID‑19 outside research settings [3] [4].
1. WHO’s formal stance: “not for routine use, only in trials”
WHO’s public position—first widely cited in 2021—was to recommend against using ivermectin for COVID‑19 except within properly conducted clinical trials; that warning was communicated by WHO scientists and repeated in reporting of the agency’s living guideline assessments [1] [2]. The WHO living guidelines reviewed randomized trials and judged the certainty of evidence around ivermectin’s effects on mortality, hospital admission and viral clearance to be very low or insufficient, underpinning the recommendation against routine clinical use [2].
2. Why WHO and others reached that conclusion: weak, inconsistent trial evidence
Systematic reviewers and WHO examined randomized and nonrandomized trials and found the data inconsistent, of low certainty, or inadequate to show a meaningful clinical benefit. Some meta‑analyses led by advocacy groups reported large effects, but WHO and other regulators judged much of the evidence to be low certainty or at risk of bias, leaving the balance of benefits and harms unresolved for routine care [2] [1].
3. How other major agencies lined up: FDA and NIH positions
The U.S. Food and Drug Administration has explicitly stated it has not authorized or approved ivermectin for prevention or treatment of COVID‑19 and warned of risks from inappropriate use or overdose [3]. Summaries of treatment guidance indicate the NIH and European regulators also did not recommend ivermectin for COVID‑19 outside clinical trials after reviewing the trial record [4] [3].
4. Large trials and later evidence: null or unclear treatment effects
Well‑conducted randomized trials reported in high‑quality journals found no clear benefit of ivermectin for preventing progression or reducing hospitalizations in mild‑to‑moderate outpatients; trial authors described the efficacy as unclear or absent, even when safety signals were limited or adverse events rare [5] [6]. By 2023 and later syntheses, major reviews and clinical trial platforms concluded the drug did not reliably reduce COVID‑19 symptoms or mortality [7] [5].
5. Competing voices and advocacy: persistent disagreement
A vocal set of clinicians and groups (for example, the Front Line COVID‑19 Critical Care Alliance) and meta‑analyses they cite argue ivermectin shows strong signals of efficacy and reduced mortality; those analyses appear in preprints and alternative repositories and claim sizable benefits [2]. WHO and regulatory bodies explicitly weighed these claims against trial quality concerns and still judged the overall evidence insufficient for routine recommendation [2].
6. Real‑world policy fractures: some governments and prescribers diverged
Despite WHO guidance, some local or national authorities and practitioners adopted ivermectin in COVID‑19 treatment protocols or prophylactic strategies early in the pandemic; this divergence prompted WHO warnings and public disputes about evidence and public health priorities [1] [8]. The split reflects different thresholds for emergency use, local politics, and the appeal of low‑cost, widely available drugs [1].
7. Safety and misuse concerns that influenced recommendations
Regulators have flagged safety risks from off‑label human use and from people taking veterinary formulations; reported harms include overdoses and adverse neurological or cardiovascular events, supporting conservative guidance against widespread, unsupervised use outside trials [3] [6].
8. What “as of 2025” means in practice
Available sources through 2025 show WHO’s recommendation remained: do not use ivermectin for COVID‑19 outside clinical trials because trial evidence is low certainty or negative for clear benefit [1] [2]. Other authorities—FDA, NIH—reach similar conclusions and have not authorized ivermectin for COVID‑19 [3] [4].
Limitations: available sources do not mention any WHO reversal in 2024–2025 beyond reiteration of the 2021/ongoing guidance, and they do not provide the exact text of any 2025 WHO update; reporting and advocacy meta‑analyses continue to differ on interpretation of the data [2] [1].