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India on Sunday slammed the door shut on export of Remdesivir, as demand for the anti-viral drug surged following a dramatic increase in covid-19 cases. The ban will remain in place until the pandemic loosens its stranglehold. Mint explores.

What is the use of Remdesivir?

Remdesivir is an injectable anti-viral formulation that was developed by US-based Gilead Sciences in 2014 to treat Ebola viral disease. As the coronavirus swept the world last year and a vaccine was nowhere in sight, Remdesivir was repurposed to treat the covid-19 respiratory disease. It is given to moderate and severely sick patients, aged 12 and above, in hospitals, although the World Health Organization (WHO) has said there’s no evidence that the drug improved survival and other outcomes. The drug prevents secretion of a specific enzyme that’s vital for the virus to replicate.

Why this sudden shortage?

This is due to a spike in covid-19 cases in recent weeks and supply bottlenecks. India has been reporting daily infections in excess of 150,000 for the past few days, about 50% more than the US and Turkey put together. Indian firms cut production of Remdesivir starting December, as the covid curve plummeted and demand for the drug evaporated. A ferocious resurgence has reportedly prompted hoarding by stockists and individuals alike, and, together with over-prescription, has inflated prices. It’s not easy to quickly raise output due to a lag in delivery of raw materials.

Production capacity
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Production capacity

Which firms make this drug in the country?

Seven Indian pharmaceutical firms, including Hetero Drugs, Zydus Cadila and Cipla, produce Remdesivir injections under a licensing agreement with Gilead. They have a combined capacity to produce about 3.9 million vials a month. Zydus slashed the price in March to 899 for a 100 mg vial, the cheapest in India, from 2,800.

Why is India in this sorry covid state?

The current situation is the result of a lack of preparedness. When cases in India began sliding, Europe and the US were in the throes of second and third waves. It was inexplicable for authorities to have imagined that India’s covid crisis had “de-coupled", and that we won’t have a resurgence. Our vaccination drive has been tardy, and now faces dose shortages, as the government neither offered financial help to vaccine makers, nor signed purchase orders or paid up in advance, hampering capacity expansion.

What does this mean for the economy?

The second wave has prompted partial lockdowns in several states. Maharashtra, India’s financial nerve centre and the worst-hit state, is staring at a complete lockdown. Cases are spiralling in several other industrial states, including in Delhi. Spooked by last year’s horrid experience, migrant labourers are heading back to their villages. A broader set of curbs will snap off supply chains, and hamper economic activity, hurting consumption demand, a prospect that saw the benchmark BSE Sensex plunge 3.4% on Monday.

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