Trump seeks tablets India has quarantined Limited supplies amid the rising global demand

G.S. Mudur, TT,  6.04.20, New Delhi: President Donald Trump has requested Prime Minister Narendra Modi to release hydroxychloroquine tablets, an anti-malarial drug that has become hot property across the world after some countries started using it to treat Covid-19 patients.

Trump’s request during a phone call to Modi was made on the same day India tightened rules banning the export of hydroxychloroquine. The export ban, without exceptions, came after the Union health ministry changed the national treatment guidelines to include a regimen of hydroxychloroquine and azithromycin to treat Covid-19 patients.

Various studies have over the past decade indicated that this anti-malarial drug might lessen the impact of certain viral infections, including Covid-19. No cure or vaccine has yet been found for the coronavirus disease.

Although the Indian government had on Saturday mentioned the phone conversation between Trump and Modi, it had not explicitly disclosed that the US President had made a request for the now-coveted tablets.

Nor did Modi refer to any specifics when he tweeted on Saturday: “We had a good discussion, and agreed to deploy the full strength of the India-US partnership to fight Covid-19.”

A statement by the Press Information Bureau took care to mention that “the two leaders also touched upon the significance of practices as such as yoga and ayurveda (traditional Indian herbal medicine practice) for ensuring physical and mental well-being in these difficult times”. But the statement made no reference to the purported request by Trump for the tablets.

However, at his daily news conference at the White House on Saturday, Trump was quoted by PTI as saying: “I called Prime Minister Modi of India this morning. They make large amounts of hydroxychloroquine. India is giving it serious consideration.”

“I said I would appreciate if they (India) would release the amounts that we ordered,” the US President, who shares a good rapport with Modi, added without specifying the quantity ordered from India.

Trump may have disclosed the request before any public assurance from India because he was eager to reassure the people of the US, which has become the new epicentre of the coronavirus outbreak.

The US had till April 4 recorded more than 250,000 confirmed cases and more than 5,800 deaths from the coronavirus disease.

On the day Trump made the request to Modi, India’s directorate-general of foreign trade (DGFT) had closed a window that would have allowed some exports of the drug.

On March 25, the DGFT had banned the export of hydroxychloroquine but indicated that shipments would be allowed from special economic zones and export units on humanitarian grounds, or if the exporters had received full advance payment.

On Saturday, the DGFT issued a fresh order that expanded the ban without exception.

“The export of hydroxychloroquine and formulations of hydroxychloroquine is no longer allowed from special economic zones/ export-oriented units, or against full advance payment…. The export shall remain prohibited without any exception,” the DGFT said in a notification. 

Hydroxychloroquine had been developed decades ago and used against malaria and rheumatoid arthritis but was viewed as a low-priority product until it gained fresh prominence during the coronavirus pandemic.

The Indian Council of Medical Research (ICMR) has recommended the use of hydroxychloroquine to treat healthcare workers engaged in the care of Covid-19 patients and household contacts of Covid-19 patients.

A senior pharmaceutical industry executive told The Telegraph that five large domestic companies — Cipla, IPCA, Intas, Wallace and Zydus Cadila — were producing hydroxychloroquine, procuring the pharmaceutical ingredients from foreign as well as domestic sources.

“It is our assessment that the companies are ramping up production. They have been in a position to meet domestic and export demands earlier,” said Ashok Kumar Madan, executive director with the Indian Drugs Manufacturers’ Association. “They are now increasing production, but whether they can continue to meet the demand will depend on how the demand for the drug rises as the epidemic grows,” Madan said.

India on Sunday night had 3,219 “active” coronavirus patients in hospitals from a total count of 3,577, among whom 275 have recovered and 83 have died.

Public health experts and virologists expect the number of cases to continue to rise in the coming weeks — slower than it would have in the absence of the lockdown.

Sections of the medical community have expressed concern that limited supplies amid the rising global demand might scupper the plans to use hydroxychloroquine in the battle against the coronavirus.

Some doctors in India are privately discussing the option of mass prophylaxis (administration of hydroxychloroquine as a preventive measure) of “high-risk” people — such as the elderly and people with underlying illnesses — at least in the infection hotspots.

But Italian doctors cautioned last week in the Annals of Rheumatic Diseases, a medical journal, that such mass prophylaxis could impact supplies. “If mass prophylaxis was accepted as an option worldwide, this would raise the question of whether there is enough supply to support this approach,” they wrote.

Additional reporting by PTI