India ready to boost hydroxychloroquine output despite Covid-19 doubts

A doctor wearing a protective suit takes a swab from a man, who is under home quarantine, to test for coronavirus disease (COVID-19), at a neighbourhood in Ahmedabad, India, April 7, 2020. REUTERS - AMIT DAVE

India is the biggest manufacturer of the anti-malarial drug hydroxychloroquine, touted by some as a "game-changer" in the fight against Covid-19. Officials say India has enough stock of HCQ and that companies are ready to ramp up production to meet domestic as well as international demand. But clinical trials have shown limited success.

Last week Prime Minister Narendera Modi’s government decided to ban exports of the drug. But when US President Donald Trump stated that the US could "retaliate" if India does not release stocks of the drug, Indian officials agreed to partially lift the ban and said exports of hydroxychloroquine and paracetamol will be allowed.

With over 400,000 coronavirus cases in the Unites States – the highest in the world – and nearly 13,000 deaths, the US has ordered over 29 million doses.

Apart from receiving requests for “sizeable” orders from the US, around 30 countries, including Brazil and several south Asian nations, have asked for a supply of HCQ. Indonesia, Australia and Germany have also reportedly reached out to Indian manufacturers.

#Hydroxychloroquine ≠ benign drug. It can have devastating effect on heart muscle. On the left is normal myocardium. On the right is HcQ-mediated cardiotoxicity with prominent sarcoplasmic vacuolization. #CVPath pic.twitter.com/G4pyZ6AAb3

— Joe Maleszewski, MD (@joemaleszewski) April 7, 2020

Ready to boost production

India manufactures 70 percent of the world’s supply of HCQ, according to Sudarshan Jain, secretary general of the Indian Pharmaceutical Association.

“The production capacity is sufficient to meet the current demand and if the need arises, the companies are committed to ramping up production,” said Jain.

The Mumbai-headquartered Ipca Laboratories confirmed that only 10 percent of its manufacturing capacity of HCQ had been used for the domestic market so far.

Hydroxychloroquine, the anti-malarial drug, is under global spotlight in the fight against Covid-19 © Murali Krishnan

Prescription use only

HCQ is an anti-malarial drug derived from chloroquine, which has a higher toxicity. It is prescribed in certain cases of malaria and doctors also use it to treat rheumatoid arthritis and lupus.

But top scientists and researchers have urged people not to take the drug solely on suspicion of having contracted Covid-19. They warn that it should not be consumed without a doctor's prescription, as the medicine has side effects.

“The ICMR has approved to give hydroxychloroquine in some cases but it was still at an experimental level. It is being recommended only for asymptomatic healthcare workers involved in the care of suspected or confirmed cases of Covid-19 and asymptomatic household contacts of laboratory-confirmed cases,” said scientist Raman Gangakhedkar.

‘#Hydroxychloroquine is a safe drug. It has been given to 10’sM of people since its approval in 1955 & as a monotherapy hasn’t been assoc. w/any deaths in the rec dose. In 42 yrs of practice, no patient of mine has ever been hospitalized for a HCQ complication’. ~Dr. Dan Wallace

— Karen Giorno (@krgiorno) April 8, 2020

Only a few clinical trials have shown any success in treating Covid-19. Despite some early promising results in China and France, the European Medicine Agency has emphasised that its efficacy in treating the coronavirus disease is yet to be proven.

Days after the US Food and Drug Administration gave emergency approval to HCQ treat Covid-19, European regulators are limiting their use to clinical trials only.

Two large trials are currently under way on the effectiveness of HCQ and even chloroquine.