U.S., India spar over antimalarial as COVID-19 highlights state actor role in supply chain

President Donald J. Trump's endorsement of antimalarial hydroxychloroquine to treat COVID-19 has sent demand for the drug skyrocketing. But a tussle with India, a major U.S. drug supplier, over an export ban has added new concerns about the role of state actors in the global supply chain. 

The U.S. and Indian governments are wrangling over supply of hydroxychloroquine, an antimalarial drug being evaluated to treat severe COVID-19. India instituted a full-scale export lockdown of the drug last week and then agreed to partially lift the ban days later after Trump intervened, Newsweek reported.

India, which produces around 47% of the U.S. supply of hydroxychloroquine, according to Bloomberg Intelligence, will reportedly license its stock of hydroxychloroquine to "badly affected" nations and countries who rely on its supply of the drug.

On Saturday, during the White House's daily coronavirus press briefing, Trump said he had appealed directly to Indian Prime Minister Narendra Modi to ease the export moratorium, which expanded a previous ban on overseas shipments with the exception of meeting prior commitments and humanitarian needs, Time reported

Trump has touted a combination of hydroxychloroquine and antibiotic azithromycin as a potential "game-changer" in the race for a COVID-19 therapeutic as the pharmaceutical industry cycles a number of older meds through clinical trials to determine their efficacy in treating the disease. The FDA last week posted shortages of chloroquine and hydroxychloroquine due to increased demand partly tied to Trump's explicit endorsement.

Even with a temporary win for the U.S., India's move to shore up its own domestic supply could cause rippling concerns over the stability of the global pharmaceutical supply chain amid the novel coronavirus pandemic. 

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