The past couple of days have witnessed diplomatic bonhomie and great PR initiative by India after Modi-Government lifted the ban on the export of hydroxychloroquine (HCQ) drug that is required by many countries to fight the coronavirus pandemic.

Earlier, the US and Brazilian Presidents — Donald Trump and Jair Bolsonaro respectively expressed their gratitude towards Narendra Modi after the Indian PM lifted the ban on the export of Hydrochloroquine allowing for the timely dispatch of the drug which is touted as a possible cure to Covid-19.

“Extraordinary times require even closer cooperation between friends. Thank You, India and the Indian people for the decision on HCQ. Will not be forgotten! Thank You, Prime Minister @Narendra Modi, for your strong leadership in helping not just India but humanity, in this fight!” Trump tweeted late on Wednesday night.

The Indian Prime Minister in his reply said that India will do everything possible to fight Covid-19. “Fully agree with you President @realDonaldTrump. Times like these bring friends closer. We shall win this together,” Modi replied in his tweet.

Brazil President Jair Bolsonaro in his address to his nation thanked Modi and said that Brazil will receive all the raw materials required to produce HCQ to treat Covid-19 patients as well as Malaria, lupus, and arthritis post his conversation with the India Prime Minister. In fact, in a letter written to Modi following his call, Bolsonaro invoked Ramayana, comparing the HCQ to the Sanjeevani Booti.

Even Israel PM Benjamin Netanyahu thanked his Indian counterpart after a five-tone shipment landed in Israel within just three days of his request. However, while all the diplomatic bonhomie between India and various other nations is proudly on display for the world to see, it also has had a downside.

HCQ, an anti-malarial drug is also prescribed for patients with autoimmune diseases such as rheumatoid arthritis and lupus. However, after some Chinese and French researchers claimed that HCQ could potentially treat COVID-19 and Donald Trump called the drug a potential game-changer, patients in India suffering from rheumatoid arthritis and lupus have become anxious with the medicine quickly disappearing from medical stores.

Many doctors and hospitals have said that they are facing shortages and have decided to sell the drug only to patients with utmost emergency. In Chennai, many hospitals are giving medicine to patients suffering from severe pain and swelling.

For Systematic Lupus Erythematosus (SLE) patients, the non-availability of drugs can be fatal. Lupus is an autoimmune disease in which the body’s immune system mistakenly attacks healthy tissues and organs in many parts of the body. The daily dose for such patients is very high and can range between 250-400 mg every day.

The major reason for the scarcity of the drug is panic buying by a majority of the people who have hoarded the medicine for their self-treatment in case they or their family members catches Covid-19.

Self-medication of HCQ has proved fatal for many people in India and the world who consumed it after they believed that they had contracted COVID-19. Another pharmacist told that they had run out of stock about 20 days back.

Is There A Shortage?

India manufactures 70% of the world’s HCQ which is approximately 20 crore HCQ tablets every month while local consumption is only 2.40 crores every year.

Two Indian pharmaceutical companies Zydus Cadila and IPCA Laboratories with multiple plants in the country produce most of the drug. According to a senior functionary of Zydus Cadila, the company has ramped up its production capacity from 3 metric tons a month to about 20 to 30 metric tons and has plans to further boost it to 40-50 metric tons.

IPCA Laboratories has a capacity to produce 20 metric tons of HCQ drug and can produce 26 metric tons according to company sources. Even smaller pharmaceutical companies that produce HCQ like Wallace Pharmaceuticals have decided to ramp up their production.

The Indian Pharmaceutical Association has also tried to calm the nerves of Indians dependent on HCQ by insisting that there would not be a shortage. “The drug has vanished from the shelves because once some reports came that it was effective against Covid-19, people started buying it and hoarding it,” IPA president Prof TV Narayana told to the BBC.

The shortage, he says, is temporary, essentially because the government is trying to dissuade people from panic buying and hoarding a medicine that – if taken without medical supervision – can cause serious side effects.

The two main producers of HCQ in India – IPCA labs and Zydus Cadila – can produce 1.5 million tablets each every day. The raw material for hydroxychloroquine is locally sourced and we have sufficient stocks. IPCA also has 50 million tablets in its stock. Most Indian states too are holding on to one to two million tablets so where is the question of shortage?” he asks.

Indian Pharmaceutical Alliance Secretary General Sudarshan Jain also echoed the same sentiment. Jain said — “The production capacity is sufficient to meet the current demand and if the need arises, the companies are committed to ramping up production. The domestic demand is 3 million tablets a month and we can scale the production to 150 million to 200 million tablets a month easily.”