India has decided to partially lift the ban on export of paracetamol and anti-malarial drug hydroxychloroquine in sync with its global commitment to deal with the coronavirus pandemic, officials said on Tuesday.
Hydroxychloroquine is an old and inexpensive drug used to treat malaria. India is the largest producer of the drug globally. On March 25, India banned export of hydroxychloroquine or HCQ in the midst of views in some quarters that the drug could be used to fight COVID-19. The drug is presently being given to healthcare workers and high-risk contacts of positive patients in India as a preventive measure. The Union Health Ministry on Monday, however, noted that there is not enough evidence to support the drug being used as treatment for COVID-19.
In a telephonic conversation with Prime Minister Narendra Modi on Sunday, President Donald Trump sought supply of hydroxychloroquine to the US to treat coronavirus infected people. The US President has in the past called HCQ a ‘game changer’, despite public health experts in the US contradicting him, and warning that there is no clinical evidence to support that the drug works against COVID-19.
Trump’s warning
On Monday, Trump warned India that the US may retaliate if it did not export hydroxychloroquine despite his personal request.
At a press briefing at the White House, when asked by a reporter if Trump was worried about retaliation to the US’s decision to ban exports of certain medical goods, such as India’s ban on export of HCQ, the US President said, “I don’t like that decision. I didn’t hear that that was his decision. I know that he stopped it for other countries. I spoke to him yesterday (Sunday). We had a very good talk, and we’ll see whether or not that’s his decision. I would be surprised if he would, you know because India does very well with the United States.”
He then went on to accuse India of taking advantage of the US on trade before issuing a warning. “For many years they’ve been taking advantage of the United States on trade. So I would be surprised if that was the decision. He’d have to tell me that. I spoke to him Sunday morning and I said we’d appreciate you (PM Modi) allowing our supply to come out. If he doesn’t allow it to come out. That would be okay but, of course, there may be retaliation. Why wouldn’t there be?”
According to reports, US orders for HCQ were placed in March.
Hours later, on Tuesday, officials in India said the country would export the drug on a case-by-case basis after meeting all the domestic requirements.
"India has always maintained that the international community must display strong solidarity and cooperation. This approach also guided our evacuation of nationals of other countries," Spokesperson in the Ministry of External Affairs Anurag Srivastava said.
"In view of the humanitarian aspects of the pandemic, it has been decided that India would licence paracetamol and HCQ (hydroxychloroquine) in appropriate quantities to all our neighbouring countries who are dependent on our capabilities," he said.
The MEA spokesperson was responding to media queries on the issue.
"We will also be supplying these essential drugs to some nations who have been particularly badly affected by the pandemic," said Srivastava.
India is learnt to have received requests from at least 20 countries including its immediate neighbours Sri Lanka and Nepal for supply of hydroxychloroquine.
"Like any responsible government, our first obligation is to ensure that there are adequate stocks of medicines for the requirement of our own people," the MEA spokesperson said.
In order to ensure this, he explained, some "temporary steps" were taken to restrict exports of a number of pharmaceutical products. He said a comprehensive assessment was carried out about possible requirements of various drugs under different scenarios.
"After having confirmed the availability of medicines for all possible contingencies currently envisaged, these restrictions have been largely lifted," he said.
He said the Directorate General of Foreign Trade (DGFT) has notified lifting of restrictions on 14 drugs on Monday.
"With regard to paracetamol and hydroxychloroquine, they will be kept in a licensed category and their demand position would be continuously monitored," Srivastava said.
"However, the stock position could allow our companies to meet the export commitments that they had contracted," he added.
Public health expert T Sundararaman, who is the former director of the National Health Systems Resource Centre, told TNM that while it may not be possible for India to impose a blanket ban on export of such drugs given its global commitments, it is crucial that India have enough stock to supply its own needs. “We need to know whether we have stocks adequate for our requirements. And if at some point we have made orders and commitments, those orders should not be delayed because of it. Maybe we don’t need a generic export ban.”
While the US has also banned the export of certain medical equipment, Sundaraman said, “The US should also not be doing that. So we need this information – what are our needs, do we have adequate manufacturing capacity to meet our own needs and what is the US policy on other issues? And whether this is against pre-existing contracts, whether our contracts are being overrun by that?”
When asked about the impact of the Indian government’s move in India’s fight against COVID-19, Sundararaman said, “This isn’t a drug that is yet to be approved, but given the fact that it is under testing, we must ensure that production is on scale to meet our requirements.”
Congress accuses Modi of surrendering to US
Meanwhile, Congress leader Rahul Gandhi said on Tuesday that India must help all countries in their fight against coronavirus but lifesaving medicines should be made available to Indians first.
"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," he said on Twitter.
Congress spokesperson Shaktisinh Gohil hit out at the Modi government for ‘meekly surrendering’ to the US after Trump’s threat. "It is embarrassing for the entire country that Donald Trump threatens retaliation if Indian government does not allow the supply of medicines. PM Narendra Modi who wasted one full month and Rs 100 crore for 'Namaste Trump', has now meekly surrendered and has revoked the ban on exports of medicines," tweeted Congress spokesperson Shaktisinh Gohil.
(With PTI inputs)