Coronavirus: India reverses ban on export of anti-malaria drug believed to be effective in treating Covid-19

The Indian government had earlier put a hold on exports of hydroxychloroquine and paracetamol. PHOTO: AFP

NEW DELHI - India will supply two key drugs - paracetamol and hydroxychloroquine - being used to treat Covid-19 patients to countries that have been "badly affected" by the pandemic, the Ministry of External Affairs (MEA) said on Tuesday (April 7).

This reverses a government decision on April 4 that had completely banned the export of hydroxychloroquine and follows growing international pressure on India, including from US President Donald Trump, to allow the export of these life-saving drugs.

"In view of the humanitarian aspects of the pandemic, it has been decided that India would licence paracetamol and hydroxychloroquine in appropriate quantities to all our neighbouring countries who are dependent on our capabilities," Mr Anurag Srivastava, the MEA spokesman said on Tuesday morning.

"We will also be supplying these essential drugs to some nations who have been particularly badly affected by the pandemic," he added.

The most vocal demand for India to resume exports of hydroxychloroquine has come from the United States, whose president on Monday even warned India of retaliation over its decision to ban its export. The anti-malaria drug was developed decades ago but has become a coveted pharmaceutical product in recent weeks as it is believed to be effective in the treatment of Covid-19.

"If he (Indian PM Narendra Modi) doesn't allow it to come out, that would be okay, but of course there may be retaliation. Why wouldn't there be," Mr Trump said at a White House press briefing. He had also spoken to Mr Modi on Saturday, urging him to release the drug for export to the US.

Anticipating a rise in demand for hydroxychloroquine, given the rapidly growing number of coronavirus cases in India, the Directorate General of Foreign Trade (DGFT) had placed restrictions on the drug's export on Mar 25. It said it would allow exports only from firms that had already received full payment prior to the government's order or if the drugs were being exported from special economic zones or export-oriented units to fulfil pre-existing obligations. Exports on humanitarian grounds were also exempted from the ban.

On Apr 4, however, the DGFT issued a fresh order that expanded the ban "without any exception".

Coronavirus cases in India have risen sharply from just 110 on March 15 to 4,421 on Apr 7. The Indian Ministry of Health and Family Welfare had on Mar 31 amended the national treatment guidelines for Covid-19 patients and recommended a regimen comprising hydroxychloroquine and azithromycin as an "off-label indication". While a recent study in France showed that the anti-malarial drug may help mitigate the impact of the novel coronavirus, doctors across the world are still divided on the drug's efficacy.

Its use also comes with potential side effects such as vision loss and heart problems but its demand has grown significantly in the US, where Mr Trump has endorsed it emphatically. "I may take it," he had said at a press briefing last week. "We're just hearing really positive stories, and we're continuing to collect the data," he was quoted as saying in a Reuters report.

Mr Trump's remarks calling for retaliation have prompted criticism from Indian opposition leaders, some of whom have even accused the government of capitulating to American pressure.

Following the MEA statement on Tuesday, Congress leader Rahul Gandhi tweeted: "Friendship isn't about retaliation. India must help all nations in their hour of need but lifesaving medicines should be made available to Indians in ample quantities first."

Data compiled by Bloomberg Intelligence shows 47 per cent of the United States' supply of the drug in 2019 came from India, the world's biggest maker of generic drugs. Some of India's largest pharmaceutical firms, including Cipla, Ipca, Wallace and Zydus Cadila, produce hydroxychloroquine using active pharmaceutical ingredients (API) sourced from foreign, particularly China, as well as domestic sources.

A representative from an Indian pharmaceutical firm manufacturing the anti-malaria drug told The Straits Times it expected to ramp up production from a monthly average of 100 million pills to 200 million by marshalling additional manufacturing capacity currently being used to produce other medicines at other plants.

However, the ability of Indian firms to cope with the sudden surge in demand depends greatly on their access to ingredients imported from China and used in manufacturing hydroxychloroquine. "The price of raw material coming in from China has already doubled," he said, adding that his company had stepped up efforts to locally produce these intermediates.

Mr Ashok Kumar Madan, executive director with the Indian Drugs Manufacturers' Association, told The Straits Times that the pharmaceutical industry in India was equipped to address current domestic as well as international demand for hydroxychloroquine and that its members had already started ramping up production.

"Whether we are able to respond to future demand depends a lot on how the domestic situation evolves. If the demand here increases exponentially, we will have to cater to domestic demand first and then share the surplus with others," Mr Madan said, also flagging the importance of ensuring uninterrupted supply of pharmaceutical ingredients from China.
"The final call on exports is one that has to be taken by the government," he added.

The MEA has said the decision to permit export of paracetamol and hydroxychloroquine follows a "comprehensive assessment" of possible requirements. The two drugs will, however, continue to be kept in a "licensed category" and their demand position will be continuously monitored, it added.

The decision announced on Tuesday comes at a time when the government is considering extending the three-week nationwide lockdown that ends on April 14, following requests from many state governments.

Telangana chief minister K Chandrashekar Rao is among those who have pitched for extending the lockdown. Minister for Information and Broadcasting Prakash Javadekar told the media on Monday that a decision would be taken "in the national interest" at the right time.

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