While it is true that ivermectin has not been conclusively proven effective against COVID-19 in large, high-quality randomized controlled trials (RCTs), this does not mean its potential is entirely unexplored or dismissed. The *PLOS ONE* meta-analysis, though criticized for methodological limitations, was part of a broader body of research that included both in vitro and small clinical trials suggesting possible antiviral effects. These studies, while not definitive on their own, contributed to a growing body of evidence that warranted further investigation. The lack of large-scale, high-quality RCTs is not unique to ivermectin—it reflects the challenges of conducting such trials during a rapidly evolving pandemic, especially with limited resources and time.
Regulatory agencies like the FDA and WHO have indeed set high standards for drug approval, and these are justified to ensure patient safety and treatment efficacy. However, the absence of conclusive evidence does not equate to a complete dismissal of all potential benefits. The WHO and other organizations have acknowledged the need for more research, and some countries have used ivermectin in specific contexts, such as in combination with other therapies, under strict monitoring. This suggests that while the evidence is not yet robust enough for widespread use, the scientific community continues to explore its potential. It is important to distinguish between what is *proven* and what is *still under investigation*, and to avoid conflating the two.