New Delhi: Motivational speaker, educationist and disability rights activist Priya Bhargava has been intermittently using hydroxychloroquine for the past fifteen years. A long-time patient of lupus with transverse myelitis, Bhargava needs the anti-malarial drug to keep the symptoms of lupus, an auto-immune disease that causes the immune system to attack healthy blood cells in the body, in check.
However, since the recent celebrity status of hydroxychloroquine after China lauded it as a possible cure for coronavirus, the drug seems to have become harder to find in stores. Bhargava, a resident of Noida who uses a wheelchair due to her condition, enquired from local chemists last week when her supply of HCQ ran out, only to be told it was out of stock. She also searched for the medicine online on sites like Pharmeasy but was unable to procure any.
"Last week when I was down to my last strip of HCQ, my doctor warned me to acquire some more as he suspected there could be a shortage. Sure enough, all three pharmacies in Sector 37, Noida, told me it wasn't available," Bhargava told News18.
A former beauty queen, Bhargava, who is the winner of "Miss Wheelchair India 2015", called 112, the emergency helpline number provided by the UP government for residents in need of essential supplies and medicines. The woman who responded to the call told Bhargava that the drug was available in certain pharmacies but that she would have to personally carry her prescription to the store to get it.
"I told her I was a wheelchair user. She asked me to go in a car. That was rather insensitive," Bhargava said, adding, "You are delivering food and vegetables to people's doorsteps but not delivering essential medicines to someone with special needs".
Bhargava finally managed to the prescribed dose of medicine after contacting some senior doctors. "But it was only because of my personal contacts that I could get the drug".
Such instances have been widely reported in the media in the past two weeks. With all eyes currently trained on novel coronavirus, the demand for HCQ - which allegedly has anti-viral properties - has shot up around the globe and many non-coronaviral users of HCQ have reported a shortage. The situation became even tenser after the Indian government gave in to pressure from the United States and agreed to export the drug last week.
Despite the government and Ministry of Health assuring citizens that HCQ was in enough supply, many like Bhargava have been unable to directly procure the drug - used to tame overactive immune systems - from pharmacies.
A similar problem was faced by 39-year-old math teacher and social activist Vikas Kumar from North East Delhi's Burari. Kumar suffers from rheumatoid arthritis which causes severe joint pain and he takes the prescribed dose of HCQ to keep the pain in check. "From March 20th onwards, I was told by chemists that the drug is unavailable," Kumar told News18. He visited a number of shops in Burari and nearby Sant Nagar areas but in vain.
"The problem is not the unavailability of HCQ but the fact that some chemists have now started to hoard the drug and only giving it out to long term customers," Kumar alleged. He said that he himself saw this happen at a chemist's in Sant Nagar. "The shop got a consignment of the tablets in front of me but the chemist told me they are out of stock," Kumar said.
HCQ is currently being produced by two companies, Zydus Cadila and Ipca Labs.
Ipca officials maintained that there is no shortage of the drug. IPCA has even started a helpline to help connect patients and customers to pharmacies that have supplies of the drug. Chemists, however, have confirmed that there indeed has been a spike in demand.
"When the news of HCQ being used to treat coronavirus broke, those who regularly use it went into panic mode and ordered several strips from multiple pharmacies," Abhay Puri, who runs a pharmacy in Sant Nagar, told News18. "So now, we refuse to give the drug to customers who don't have their doctor's prescription and reference," he added.
Abhay further said that since the drug was classified as a Schedule H1 drug by the government of India in March, pharmacies now needed to maintain detailed records of customers getting HCQ along with their prescription details along with details about the doctor treating the patient. Those coming with older prescriptions or prescriptions from doctors who aren't personally treating them are being denied the drug.
Rahul Shrivastava, a Noida resident who has been volunteering with a group called "Project Delhi", has been providing aid to people with disabilities who are facing problems during the lockdown. He confirmed that in the past week, he has received several calls from panicked patients who were unable to leave the house to get medicines.
While the Indian government and health ministry assured Indians that there was no shortage, Shrivastava maintains that availability was not the only problem.
"Even if the drug is available, not everyone can search for it in local pharmacies amid lockdown. This is especially true for people with disabilities and no transport," he said. The banking sector employee felt that the government at both central and state level needed to ensure that essential services like medicines were delivered to the doorsteps of those in need.
HCQ has been repeatedly endorsed not just by China but by US President Donald Trump as well who on March 21 referred to the combination of hydroxychloroquine and azithromycin as one of the “biggest game-changers in the history of medicine”.
HCQ manufacturers Ipca and Cadilla, as well as other manufacturers of the drug such as Cipla, Lupin along with API suppliers of HCQ, will be ramping up production scale for the drug by the end of this month. India has already reserved 10 crore tablets as personal stock.
With over five lakh positive coronavirus cases and over 24,000 deaths in the US alone, however, demand for the medicine is only likely to rise. Both US, as well as China, do not produce HCQ and their arm-twisting techniques to acquire supplies of the drug may end up costing Indian consumers dearly.