Panic-struck people clear out faintly promising malaria drug
On Sunday, Salman Islam, a resident of the capital's Panthapath area, rushed to the nearest pharmacy to buy malaria drug hydroxychloroquine after watching on the news that the US President Donald Trump touted it for treatment of Covid-19.
To Islam's surprise, the pharmacist told him that the drugs are not available; they were all taken by a customer a couple of minutes back.
"I searched three other pharmacies only to hear the same words: 'sold out'," Islam said.
The basis of Trump's claim is a controversial, small study of about 40 patients hospitalised with Covid-19 in France.
In that study, hydroxychloroquine was given with the antibiotic azithromycin to the patients and the medication appeared to help clear the virus from the bodies of 26 patients, based on samples taken from nasal swabs, reports Bloomberg.
Experts have criticised the design of the study, calling it interesting but far from definitive. Top scientists, including White House coronavirus task force member Anthony Fauci, have called reports that hydroxychloroquine might work anecdotal, and said they need further study before the pill's use is encouraged.
And yet, that has not stopped panic-stricken people from snapping up the drug, leaving genuine patients without supply.
The Daily Star yesterday visited nine pharmacies in the capital's West Rajabazar, Panthapath and Kalabagan areas but none of them had hydroxychloroquine. But azithromycin was available in all the drugstores.
Hydroxychloroquine is used to treat malaria, lupus erythematosus, rheumatoid arthritis and autoimmune disorder.
"Chloroquine drug was not a top-selling product for us. Some people would buy a few tablets before boarding on a bus to Hill Tracts and some for arthritis," said Md Fariduddin, proprietor of Lopa Pharmacy in the capital's Panthapath.
Chloroquine is a prescription-only drug, said Abid Hasan, a pharmacist of Kalabagan's Lazz Pharma.
And yet, it is out of market, not just in Bangladesh but in neighbouring India too, which is giving more credence to the medicine in treating Covid-19 that has brought the world down to its knees.
The neighbouring country yesterday placed a ban on its export with immediate effect.
The ban comes two days after Indian Council of Medical Research (ICMR) Director General Balram Bhargava had on Monday recommended the use of hydroxychloroquine for treating healthcare workers dealing with suspected or confirmed coronavirus cases and also asymptomatic household contacts of the lab-confirmed cases of the pandemic.
The treatment protocol recommended by the ICMR-constituted National Task Force for COVID-19 has been approved by the Drug Controller General of India for restricted use in emergency situations.
The Indian government though will allow export of the medicine on humanitarian grounds on case-to-case basis on the ministry of external affairs' recommendation, said the notification from the Directorate General of Foreign Trade (DGFT), an arm of the commerce ministry which deals with export and import-related matters.
Some research suggests antimalarial medication and antibiotics could be beneficial to Covid-19 patients, said Sitesh Chandra Bachar, chairman of the department of pharmacy of Dhaka University.
"But these drugs should be only used for severely ill patients and only with doctor's consent," he said, while warning that the use of hydroxychloroquine for preventive measures could cause severe damage.
Md Mahbubur Rahman, director general of the Directorate General of Drug Administration (DGDA), echoed the same.
The government though has adequate stock of hydroxychloroquine, which it is supply to healthcare institutions. And some select drugstore will be stocked next week.
"But we have prohibited its sales without the advice of physicians."
And to ensure smooth supply of drugs to treat Covid-19 patients, the DGDA on March 19 asked the Bangladesh Association of Pharmaceutical Industries to allow the eligible pharmaceuticals to manufacture them.
The approval was given as per the recommendation of the Bangladesh Society of Medicine and in accordance with the national guide line for Coronavirus treatment, Rahman added.
Beacon Pharmaceuticals is one such drug maker that recently got the permission to make hydroxychloroquine, according to its Vice President Md Shariar Tamal Selim.
The necessary active pharmaceutical ingredients have been collected and Beacon will be able to deliver the medicines by the end of this month, he said.
ACI has long been making the tablet of chloroquine phosphate in the name of Avloquin and the company has a capacity to produce 13 crore pieces a year in its two plants.
"It is a very old drug. And it is in the market but it may be that pharmacies are not giving anyone who is asking for the medicine without prescription," said M Mohibuz Zaman, managing director of ACI Healthcare.
This is a prescription drug and one should not buy or consume without prescription.
There are some predisposing ailments based on which doctors may or may prescribe to a particular patient. It should not be self-medicated drug like paracetamol or vitamin.
"We are producing it and there is no question of increasing the prices now," said Zaman, adding that ACI is also not exporting the drug so it can meet all domestic demand.
He said the prices of the drug is less than Tk 2 each.
Other than ACI, Incepta, Delta and Zenith Pharmaceuticals make hydroxychloroquine.
Incepta has been selling the drug in the local market under the brand Reconil for the last 18 years, said a senior official of the company wishing not to be named.
Currently, the company is supplying the drugs to the government, hospitals and clinics, both state-run and public.
It, however, has stopped supplying it to local drug stores as per a government order, said the official.
The company has also ramped up the production of the drug, said the official, without giving any specific number.