Tussle over hydroxychloroquine puts India's neighbourhood first policy at odds with efforts to appease Trump

On Tuesday, India lifted an export ban on 24 active pharmaceutical ingredients, believed to be critical in the battle against coronavirus

Karan Pradhan April 07, 2020 16:06:53 IST
Tussle over hydroxychloroquine puts India's neighbourhood first policy at odds with efforts to appease Trump

Imagine being one among the people in attendance at Ahmedabad's Sardar Vallabhbhai Patel Stadium on 24 February for the 'Namaste Trump' event. In doing so, imagine having braved the heat, dust and numerous security checks for the opportunity to hear Donald Trump speak... live and in the flesh. 'This would never have happened during Indira Gandhi or Rajiv Gandhi's time,' you might imagine yourself remarking, recalling the nature of India-US relations when the likes of Lyndon B Johnson, Richard Nixon and Ronald Reagan were in the White House.

Finally, imagine heartily applauding Trump's proclamation on the day that "America loves India, America respects India, and America will always be faithful and loyal friends to the Indian people." Imagine also noting that the President of the United States mentioned the word 'friend' or some variant no less than seven times in his short address. And finally, imagine actually having bought what he was peddling hook, line and sinker.

Now, a little over six weeks since then — an arguably simpler time when a coronavirus was something that only affected people with strange eating habits and lockdowns only happened in Kashmir — comes this latest proclamation from Trump.

Soon after, came the announcement that India would be lifting restrictions on exporting 24 active pharmaceutical ingredients (APIs) and formulations. And eventually, word emerged that paracetamol and hydroxychloroquine were back on the exports list, albeit in a 'partial' capacity. The two drugs are believed by some, including Trump who referred to the latter — normally used to treat malaria — as a 'game-changer', to be critical in the battle against the novel coronavirus .

There's a lot to unpack while trying to make sense of this episode, so let's break it into three easy-to-digest parts.

First, there's the issue of hydroxychloroquine itself. It's not just Trump who wants it, mind you. According to officials quoted by The Hindu, leaders from around two dozen countries are lining up for their fix of this apparent miracle drug. Among them is another friend du jour of India's: Brazilian president, renowned climate change denier and until very recently, COVID-19 sceptic, Jair Bolosonaro.

Aside from their shared disdain for efforts — and those making them — to address climate change, among the many things the 'Trump of the Tropics' and the regular garden-variety Trump have in common is the undying conviction that they know best. Better than trained professionals, better than area experts and much better than people who have spent their lives working towards being viewed as the authority on a particular topic. While Bolsonaro recently ignored the advice of his own health minister to take national action to prevent the spread of the coronavirus , Trump has been trumpeting the virtues of hydroxychloroquine even as the US' top infectious disease researcher Dr Anthony Fauci has been cautioning against it.

Fauci's concerns are threefold: That there is only anecdotal evidence that hydroxychloroquine works against the coronavirus , that researchers claim studies out of France and China are inadequate on account of the absence of control groups and that more data is needed to prove hydroxychloroquine's effectiveness in countering COVID-19 . But, when he isn't cracking sleazy jokes during a briefing about coronavirus cases and talking about how he 'really likes' and 'really gets' how to play medical expert, he's out undermining his administration and/or country's experts.

Never mind whether or not the drug is actually the answer to the ongoing pandemic, what's most alarming is that Trump seems either oblivious to the side effects of hydroxychloroquine or is wilfully ignoring them. This was evident on Saturday when he remarked, "[Hydroxychloroquine has] been out there for a long time. What do you have to lose? I hope they use it."

Tussle over hydroxychloroquine puts Indias neighbourhood first policy at odds with efforts to appease Trump

File image of Donald Trump and Narendra Modi. PTI

Second, there's the matter of how Trump acts when he doesn't get what he wants. When the president contradicts, and every so often insults, past or present members of his administration, it doesn't even raise an eyebrow anymore. We're even used to Trump publicly criticising, insulting and even extorting his country's allies and partners. So far as he's concerned, everyone is out to take advantage of the US.

And India is no exception.

In fact, the real estate tycoon-turned-politician said as much before speaking about possibly retaliating to India's now-scrapped ban on exporting hydroxychloroquine. As it turned out, India, it would appear, swiftly buckled under the threat and agreed to clear existing orders "depending on availability of stock after meeting domestic requirements". Perhaps it was the Memorandum of Understanding on the Safety of Medical Products signed between India's Central Drugs Standard Control Organisation and the US FDA during Trump's visit in February that forced New Delhi's hand.

While the MoU (not legally binding, incidentally) does speak of "cooperative engagement in regulatory, scientific, and technical matters and public health protection that are related to medical products the participants regulate", there's nothing in the text about threats of retaliation, nor indeed, anything about the sort of skullduggery in which Trump engaged last month. It may be recalled that his administration offered the German company CureVac "large sums of money" to gain exclusive access to their work and secure a vaccine "for the US only".

This odious act is in character as far as Trump's diplomacy goes, sitting as it does alongside his ripping-up of the Joint Comprehensive Plan of Action with Iran and demands for protection money from such treaty allies as Japan, South Korea and the NATO membership as a whole.

Third, what of the neighbourhood? According to reports, SAARC nations — Nepal, in particular, the UAE and Indonesia have asked India to lift the ban on exporting hydroxychloroquine. In its manifesto ahead of the 2014 Lok Sabha election, the BJP has stressed on the need for good relations with India's neighbours. And while Trump may have been the most recent world leader to be fêted by the Narendra Modi government, it's worth recalling that it was the SAARC leadership that was the first — invited as it was to Modi's first swearing-in ceremony in May 2014.

Tussle over hydroxychloroquine puts Indias neighbourhood first policy at odds with efforts to appease Trump

India has the opportunity to breathe life — the extent of which is debatable — into the moribund SAARC by helping its constituents, whose need for access to pharmaceuticals is in no way less significant than that of the US. After decades of being looked upon as the regional hegemon and South Asia's 'big brother', India has a chance to usher in a period of goodwill in the region by being seen to be helping its neighbours. According to India Today, government sources identified domestic consumption and the neighbourhood as priorities as far as drugs to counter coronavirus are concerned.

So where does all of this leave us?

The biggest question, however, isn't about Washington's strong-arm tactics, New Delhi's geostrategic compulsions or what the neighbourhood thinks. That honour is reserved for whether or not India has the capacity to manufacture enough volumes for its own domestic consumers, as well as the international market. Executive director of the Indian Drug Manufacturers Association (IDMA), Ashok Kumar Madan was quoted by the BBC as saying, "India definitely has capacity to cater to both global and local markets. Of course, domestic considerations must come first, but we have the capacity."

He went on to dismiss concerns of a bottleneck in terms of supply of the API used to manufacture hydroxychloroquine, noting that supplies from China had steadily continued "by both sea and air". It's worth noting that China accounts for 70 percent of India's imports of APIs required in the manufacturing of pharmaceutical products.

That hydroxychloroquine is still an unproven entity in the field of countering COVID-19 remains a matter of concern. However, if Madan's estimate of India's manufacturing capacity is accurate, then allowing the partial export of the drug isn't overly problematic. Whether or not the rationale behind partially lifting the ban had anything to do with avoiding Trump's rancour is now academic at best. What follows is of utmost importance and that is to ensure that the drug is made available to all the countries that need it, and not just a handful.

While every world leader must naturally prioritise the well-being of her/his own compatriots, Trump pushes the much-debated notion of "American exceptionalism" to toxic levels. India would do well to maintain its poise and dignity, and treat the US fairly and with the same courtesy it shows every other country. And no more. Fears of a possible trade war with Washington or some other retaliatory measures cannot cloud New Delhi's thinking. As K Chandrasekhar Rao noted on Tuesday, "The economy can be revived, but not the dead."

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