As we continue to search for new or old ways to fight the Covid-19 problem, the combination of Chloroquine or Hydroxychloroquine and Azithromycin, used by a French team of scientists, saw complete clearance of the virus within three to six days.
This was reported on March 17, and will, of course, need further study which is now ongoing. The French scientists published early data in the “International Journal of Antimicrobial Agents.”
Hydroxychloroquine is a safe and successful anti-inflammatory agent that has been used extensively in autoimmune diseases such as lupus and rheumatoid arthritis.
Chinese scientists have also been looking for effective treatment strategies against the coronavirus.
In the journal, “Cell Discovery. March 18th, 2020)” and I quote, ”We have recently reported that two drugs, remdesivir and chloroquine phosphate, efficiently inhibited Covid-19 infection in VITRO.”
Invitro means in a test tube or petri dish
I called several pharmacies, both chain and independents, and neither had any chloroquine, hydroxychloroquine, and little azithromycin in stock. These drugs when available are imported from China and India.
Physicians at a major New York hospital are now using this combination to treat patients suffering from the virus. They are able to do this by writing a prescription for it using what is known as off label usage.
Off-label prescribing is when a physician gives a drug that the FDA has approved to treat a condition different than your condition.
This practice is legal and common. It is a fact that one in five prescriptions written today is for off-label use. Insurance companies do not always pay for drugs written for an unapproved use.
The existing evidence on hydroxychloroquine points in the right direction but all the research on the drug is still in very early stages of being proven effective.
If we are now willing to try this new treatment which as of this writing still does not have the full approval of many in the medical community, the problem of supply and demand raises its ugly head.
Eyes on Asia” is a monthly newsletter with insights and analysis of the latest developments across Asia.
In a recent publication, some suggest the United States switch to India as an alternative pharmaceutical ingredient supplier to the United States.
However, doing so would be no different from rearranging the deck chairs on the Titanic.”
The problem is India depends on China for sourcing nearly three-quarters of APIs in generic drug formulation, and any disruption in the supply chain for the supply of active pharmaceutical ingredients would only make the drugs sold in the United States more expensive.
While I write about our dependence on Chinese made pharmaceuticals, there is another side to the problem.
China needs finished drugs made in the United States, China is facing a crisis of non-communicable diseases, including cancer, cardiovascular disease and diabetes.
A majority of Chinese cancer patients lack access to the most effective drugs and the cancer survival rate in China is less than half of the United States. In fact, in 2018, the Chinese government cut the import value-added tax on cancer drugs from 17 percent to 3 percent and reduced import tariffs on all common drugs and cancer drugs to zero.
Yanzhong Huang, a senior fellow for Global Health, Council on Foreign Relations and professor at the School of Diplomacy and International Relations, Seton Hall University, wrote on March 5 that “The outbreak of the new coronavirus has forced a large number of Chinese drug manufacturers to shut down.
This could be bad news for the United States, which depends heavily on China and India for its drug supply.”
Since the 1990s, U.S. drug companies have increasingly imported pharmaceutical products from India and China, where ingredients are cheaper and manufacturing is subjected to fewer regulations.
The United States also likes these two countries for its supply of generic drugs which account for 90 percent of the medicines that Americans take. India supplies 40 percent of over-the-counter and generic prescription drugs used in the United States.
Huang writes ”The FDA has asked U.S. pharmaceutical producers to evaluate their supply chains and notify the agency of any anticipated disruptions. To mitigate potential shortages, it is imperative that the U.S. government work with the Chinese government to go help Chinese manufacturers resume production and ship products to the United States as soon as possible. The top priority should be factories that product APIs and drugs that the FDA deems are most at risk of experiencing disruptions.”
Huang continues “Chinese factory closures have slowed production in India, which gets three-quarters of APIs in generic drug formulations from China. The Indian government recently ordered its pharmaceutical industry to stop exporting twenty-six pharmaceutical products, most of which are antibiotics. That decision could make shortages of certain drugs, especially antibiotics, in the United States more likely.”
The Chinese pharmaceutical industry now has 97 percent of the market for antibiotics and more than 90 percent of the market for Vitamin C, in the U.S.
The Chinese government is committed to the development of China’s own health, biotech, and pharmaceutical industries.
Pharmaceuticals and medical devices are now one of the 10 strategic industries to receive subsidies and other government support.
Bert Drachtman
Great Neck
