China stalls supplies, India faces anti-retroviral shortage

NEW DELHI: Local drug makers are facing supply disruptions from China for some active pharmaceutical ingredients (APIs) that are used in manufacturing medicines for treating coronavirus, industry executives said.

These medicines – antiretrovirals – are manufactured by around five major pharma companies in India and are supplied to various other countries apart from local use. While in the wake of global coronavirus outbreak, the demand for such drugs have surged, China is holding back supplies to meet its own demand.

“Recently, some of the scheduled consignments have not arrived and an informal communication indicates China is holding back supplies for certain APIs and intermediates that are used particularly in coronavirus drugs,” a senior executive told TOI.

Manufacturers said they presently have stocks to treat around one lakh patients but if the situation worsens, it may be a cause for worry as China is the only supplier of these APIs to India and there is no alternative source.

Lopinavir and ritonavir combination – usually a second line HIV medication – are being used in many countries to treat severe cases of coronavirus. India too used these drugs in the treatment of two Italian patients — a couple on a tour of India — who tested positive for Covid-19 in Jaipur.

Health ministry officials said on Thursday the decision to administer a combination of anti-HIV drugs- lopinavir and ritonavir- on a coronavirus-infected elderly Italian couple at a Jaipur hospital was “initially taken locally”. The hospital has been asked to inform the health ministry and the Indian Council of Medical Research (ICMR) before administering the drug combination on Covid-19 patients in future.

The Italian couple are currently undergoing treatment at SMS Hospital in Jaipur.

The Drug Controller General of India (DCGI) had approved the ‘restricted’ use of the combination of medications before they were administered to the elderly couple. The DCGI had given the approval after ICMR had sought an emergency approval for using the drugs for treating Covid- 19.

Around 70% of HIV positive patients in India are on first line drugs. The medicines are manufactured in India mainly for export purposes, mostly to African countries. However, if the coronavirus spread increases further, the drug may play a crucial role in treatment of patients.