The Crisis-ridden World is Hungry for Hydroxychloroquine

The lack of either a vaccine or a drug to combat the SARS-CoV-2 pathogen, which causes novel coronavirus decease, enabled it to sweep through the planet virtually unchecked. The sudden emergence of this virus and the alleged opacity maintained by China regarding the nature of the pathogen caught the world completely off-guard and left it largely defenseless to the pandemic.

It is said that a drowning man will clutch at even the smallest thing to keep himself afloat. when humanity doesn’t have a proven medication to treat a suddenly emerged disease, they normally look towards untested treatments in the hope that they would work. As lives are at stake, doctors can’t wait till the availability of a clinically proven, efficacious medicine to heal the patients. Against this backdrop, an anti-malarial drug called Hydroxychloroquine, which is commonly known as HCQ, emerged as a medicine that has shown some promise in treating coronavirus disease.

HCQ has originally been approved by the U.S. Food and Drug Administration (FDA) for the treatment of malaria, lupus and rheumatoid arthritis. However, preliminary research suggests that the drug may prove to be helpful in treating COVID-19. A French study performed on COVID-19 patients shows that Hydroxychloroquine in combination with Azithromycin could be an effective medicine to treat the coronavirus decease.

As the drug was showing promise, President Trump fervently advocated for the usage of Hydroxychloroquine to treat COVID-19.

In the absence of a clinically-proven drug, even the US Food and Drug Administration (FDA) allowed the use of HCQ to treat the novel coronavirus disease through an Emergency Use Authorization (EUA) issued on March 28th, 2020. Even the US FDA is not sure whether HCQ is an effective medicine. It, in its FAQ bulletin, stated that “hydroxychloroquine may possibly help very sick patients” and went on to add that “more data from clinical trials are necessary for us to determine whether chloroquine phosphate or hydroxychloroquine sulfate are safe and effective in treating or preventing COVID-19”.

As there is no unanimity among the professional bodies and researchers about the efficacy of Hydroxychloroquine, it is still regarded as an unproven drug with anecdotal evidence.

Moreover, France, where they are using HCQ to treat the novel coronavirus decease, reported many heart-related complications among the patients.

Despite the reports of side-effects and the unproven clinical capabilities of HCQ for treating coronavirus disease, the world is left with no other option except using the drug until an effective and proven remedy emerges.

Against this backdrop, nations started searching for the supplies of this vital drug to combat the rapidly spiking positive cases and ever-increasing mortalities.

India manufactures 70 percent of the world’s supply of hydroxychloroquine. As far as the manufacturing of the HCQ is concerned, there is contradictory news coming in. While many newspapers reported that the Active Pharmaceutical Ingredient (API) that is used in manufacturing HCQ is imported from China, Ajit Kumar Jain, Joint Managing Director, IPCA Laboratories, contradicted these reports stating that India makes all the starting materials needed to produce the drug in India. He also allayed the fears of shortage by stating that his company has so far supplied 4 crore tablets of HCQ, and more are on the way.

After the coronavirus pandemic hit India, the Indian government imposed a ban on some essential medicines such as Hydroxychloroquine and Paracetamol as a precautionary measure to ensure that it has enough supplies to meet its domestic requirements.

However, US President Donald Trump, speaking at a White House press briefing, warned India of possible retaliation if it doesn’t allow the export of HCQ tablets to the United States.

Brazilian president, Jair Bolsonaro, even used some Hindu mythological references to impress upon Narendra Modi while seeking the supplies of HCQ.

Under pressure, India partially lifted the ban on HCQ and approved its export to several countries.

Following the revocation of the ban, there was a thank you message from President Trump to India stating that the help ‘will not be forgotten’.

Benjamin Netanyahu, the president of Israel, also tweeted a big thank you to India and Modi.

https://twitter.com/IsraeliPM/status/1248319047785119750

After India revoked its ban on the export of HCQ, reports started emerging that Rheumatoid Arthritis (RH) and Lupus patients are finding it difficult to access HCQ.

Moreover, the Government of India has notified the hydroxychloroquine under Schedule-H1, restricting its sale only based on prescription. This move is said to have taken to stop the misuse of the drug as it is being put to prophylactic use in high-risk contacts of COVID-19 patients, especially healthcare professionals.

In some states, arthritis and lupus patients are indeed facing a shortage of hydroxychloroquine. On 10th April 2020, The Times of India reported that in the state of Telangana scarcity arose as stocks have been partially pulled from the drug stores. The Drug Control Administration (DCA) officials took stocks from pharmacies to be supplied to government-run hospitals that are treating the COVID-19 patients. Some pharmacists confirmed this news and further revealed that many patients are even ready to pay more to get HCQ.

However, the scarcity, if any, appears to be only temporary and stocks will be replenished soon. The CEO of Niti Ayog, Amitabh Kant, took to Twitter to allay the fears of HCQ shortage.

As per Pankaj Patel, CEO of Zydus Cadila, the pharmaceutical industry has significantly increased the production of hydroxychloroquine (HCQ).

Irrespective of what made India relent and revoke the ban on HCQ and Paracetamol exports, there is a widespread feeling that the world must fight this global pandemic unitedly. India’s decision to revoke the export ban on HCQ received accolades from many and may go a long way in reinforcing the global cooperation during these testing times.

During this humanitarian crisis, India’s willingness to help other countries may also give a big boost to India’s position in the international arena. And, these exports may also reinforce the reputation India pharma industry earned for itself over many years.