New Delhi: After the Narendra Modi government lifted the ban on export of hydroxychloroquine (HCQ) following US President Donald Trump’s implicit warning of ‘retaliation’, the Centre had assured the public that it had “more than enough” stock to meet local demand for the drug.

“The government of India has done proper preparation and planning regarding the current and future requirements of hydroxychloroquine. The current stock is more than enough. The government is 100% prepared to meet emergent needs,” joint secretary of health, Lav Aggarwal, had told reporters on April 9.

Despite this assurance, reports of HCQ unavailability are emerging across India.

In an order dated April 7, the Rajasthan government revealed that it had acquired a stock of 200 mg, 300 mg and 400 mg tablets of hydroxychloroquine for COVID-19 ‘treatment’. This has ostensibly led to the unavailability of HCQ in the market.

“These medicines are also regularly used by rheumatoid arthritis patients. Due to unavailability of HCQ in the markets, the arthritis patients are facing inconvenience,” reads a statement by Rohit Kumar Singh, additional chief secretary of Rajasthan’s department of medical health and family welfare.

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To deal with the deficiency, the Rajasthan government had to return the acquired stock of hydroxychloroquine tablets to pharma companies.

HCQ is an important drug used to treat several health issues. It is commonly used as an antimalarial drug. As per the Lancet Commission report released in September last year, India ranks fourth in the number of malaria cases in the world.

“India is also the only country where cases of urban malaria are also recorded. Beyond India, the threat of urban malaria [is] unclear,” mentions the report.

HCQ is also prescribed for lupus patients.

According t0 a report in The Tribune, India manufactures around 20 crore 200 mg HCQ tablets in a month and the average local consumption is estimated to be 2.40 crore tablets a year. Globally, India is a leading HCQ exporter and its HCQ manufacturing accounts for 70% of the world’s production.

A HuffPost India article notes that with the shortage of HCQ in the market, doctors are forced to form a hierarchy of patients.

The report says that in Chennai, hospitals with a stock of HCQ tablets are selectively selling only to those patients that have severe pain and swelling in joints.

“We are facing acute shortage of HCQ from the last few weeks and are left with no option but to prioritise our patients according to their health conditions,” Sham Santhanam, a city-based rheumatologist was quoted as saying.

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Even in Ahmedabad, the manufacturing hub of HCQ, the shortage of medicine is visible.

“If the supply chain was disrupted in other parts of the country, HCQ should have been available here as the city is a major production hub for the drug. But my patients, too, have been facing scarcity since the last few weeks,” Puja Srivastava, a rheumatologist based in Ahmedabad told HuffPost India.

Meanwhile, the Indian Council of Medical Research (ICMR) has restricted the use of HCQ drug for preventive purposes among two high-risk categories of people, one, healthcare professionals taking care of COVID-19 patients and two, contacts of patients.

“Hydroxychloroquine should be used as per norms. This medicine can be harmful to people suffering from cardiac problems. Hence, HCQ should be used only by the specified categories of people,” Lav Aggarwal had said.