The hydroxychloroquine hype
India likely to embrace unproven drug for virus after Trump declaration
NEW DELHI — President Donald Trump’s declaration that he was taking a malaria drug of dubious effectiveness to help fend off the coronavirus will likely be welcomed in India.
Trump’s previous endorsement of hydroxychloroquine catalyzed a tremendous shift in the South Asian country, spurring the world’s largest producer of the drug to make much more of it, prescribe it for front-line health workers treating the virus and deploy it as a diplomatic tool, despite mounting evidence against using the drug for COVID-19.
Trump said this week he was taking hydroxychloroquine as a measure of protection against the virus. The U.S. Food and Drug Administration, however, has cautioned against using it outside of hospitals because of the risk of serious heart problems.
Suhhil Gupta, a pharmacist in New Delhi, said Trump’s announcement shouldn’t carry any weight in India. “He’s not a pharmacist,” Gupta said.
Still, India’s policy on the decades-old drug, used to prevent malaria and treat lupus and rheumatoid arthritis, drastically changed after Trump tweeted in March that the drug, used with an antibiotic, could be “game-changers” in the fight against the pandemic.
India’s Health Ministry quickly approved it as a prophylactic for health care workers and others at high risk of infection, and as a treatment for critically ill patients. Officials in Mumbai even drew up a plan to administer hydroxychloroquine to slum dwellers.
Indian health officials have repeated requests for comment.
Rules say that drugs such as hydroxychloroquine be used only after a rigorous scientific and ethical review, continued oversight by an ethics committee and ensuring informed consent — none of which happened with hydroxychloroquine, said Dr. Amar Jesani, a medical ethics expert.
The Mumbai proposal was ultimately shelved amid questions of the ethics of administering the malaria drug without first subjecting it to clinical trials. Still, the Indian government has recommended more people use it, contravening 2017 rules for emergency use of untested drugs,
declined
Jesani said.
India initially banned hydroxychloroquine exports, but lifted the ban after Trump threatened “retaliation.” At the same time, India’s government ordered manufacturers to ramp up production from 1.2 million to 3 million pills a month — causing company shares to skyrocket. From the U.S. to Australia, sales jumped.
Officials have even said that Indian plantations could increase the growing capacity of cinchona trees, whose bark contains the compound quinine, which has been used to treat malaria since the 1860s. Quinine can also be made synthetically.
The Indian government purchased 100 million hydroxychloroquine pills, according to government data, to distribute to states and donate to countries including Afghanistan, Myanmar and the Dominican Republic.
India is the world’s largest producer of generic drugs, a fast-growing industry that has brought down pharmaceutical prices globally. During the HIV/AIDS crisis, India played a similar role as in the coronavirus pandemic, boosting global supplies of life-saving drugs.
The problem this time, experts say, is that the hydroxychloroquine hype is based on a flimsy study, with little to no evidence that it prevents or treats COVID-19.