In time of need: On hydroxychloroquine export

Irrespective of whether India bowed to U.S. pressure, it is unlikely to run out of the drug

After imposing a blanket ban on the export of anti-malaria drug hydroxychloroquine on April 4, without exemptions on humanitarian or other grounds, India reversed the policy two days later. The decision to reverse the ban was made public hours after U.S. President Donald Trump warned of “retaliation” if India withheld supplies of the drug for which orders had already been placed. Given the circumstances, it would be difficult to believe that the decision to lift the restriction was taken independent of U.S. pressure. But the pandemic has seen several countries displaying solidarity and cooperation providing essential supplies to others even while tackling the novel coronavirus in their own backyards. Prime Minister Narendra Modi’s message to Mr. Trump that “India shall do everything possible to help humanity’s fight against COVID-19” should, therefore, be seen in that light. Lauded as the pharmacy of the global south, India’s decision to export the drug on humanitarian grounds to neighbouring countries and others that have been badly hit by the pandemic is welcome. Till recently India relied solely on other countries for test supplies and may look to others for essential materials if the situation worsens. Also, India may have much to gain from the U.S. in the future by this diplomatic act of supplying the drug at a crucial time. The sudden demand for hydroxychloroquine across the world arose after Mr. Trump championed it as treatment for COVID-19 patients. The drug became much sought-after in India after the Indian Council of Medical Research approved its use as prophylaxis for novel coronavirus by certain categories of people on March 23. Two days later, the drug was placed in the restricted category for export and included in schedule H1 on March 26 to prevent its sale over the counter, thereby preventing self-medication and hoarding. This was also to ensure its availability to people with rheumatoid arthritis and other conditions.

India has a production capacity of 200 million hydroxychloroquine tablets of 200 mg strength each month and three well-established pharmaceutical companies make the drug. While the capacity is sufficient to meet the current demand, the companies are confident of ramping up production if the need arises. In all likelihood, in the short term, India might not run out of hydroxychloroquine as the national taskforce for COVID-19 had relied on weak, anecdotal evidence to make the recommendation. Though the U.S. Food and Drug Administration issued an emergency use authorisation for the drug to treat COVID-19 patients, on April 7, the Atlanta-based Centers for Disease Control and Prevention revised its position saying there is no drug available to prevent or treat COVID-19. Clearly, more research work is needed to establish the efficacy of the drug.