The author, Rita Ratnam, is a retired educationalist living in New Delhi. She is in her early 80s and suffers from rheumatoid arthritis, an autoimmune disease. She has been set back by the recent shortage of hydroxychloroquine, a drug that the Indian Council of Medical Research recently recommended as a prophylactic for healthcare workers at increased risk of contracting the new coronavirus. Hydroxychloroquine sulphate is an important drug in the management of rheumatoid arthritis. Her article is published in full below.
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American President Donald Trump is now insisting that India release consignments of the drug hydroxychloroquine sulphate (HCQS) to the US – and India is giving it serious consideration.
If this is not fake news, it has rung alarm bells! First, because the US request comes after India announced the ban on export of HCQS. Second, India requires this drug as the pandemic is also at our door and additionally, it is an essential drug for the treatment of several other ailments.
In India, HCQS is now being given as a prophylactic for healthcare workers, who are at higher risk of contracting the new coronavirus, and rightly so. Unfortunately, HCQS is in acute short supply. So India’s response to the US that as a ‘responsible country’ it will do all it can to supply the anti-malarial drug is a matter of concern. But the clarification that stockpiling the drug is for its own population in the event of the worst-case scenario has given something to cheer.
However, what is disheartening is that the same drug, dispensed when people are diagnosed with malaria or lupus, is also the drug prescribed as a compulsory daily dosage to those like me afflicted genetically or otherwise by rheumatoid arthritis (RA), an auto-immune disease[footnote]A condition in which the immune system attacks its own body.[/footnote].
My recent predicament represents such a situation. Having run out of my monthly stock of HCQS, I have been trying for the last three weeks to access this drug from various pharmacies. The ground reality is that daily calls to various pharmacies always meet with the same response: “Out of stock”. The latest information received is that it may not be available for at least another few months.
Non-availability could be due to hoarding by the people, manufacturers or stockists and dealers. However, the absence of this drug from the shelves of all pharmacies is creating anxiety among HCQS users like me. Unlike COVID-19, RA may not be fatal within a few weeks, but the discontinuation of HCQS even for a few days could lead to reduced immunity and subsequently to irreversible physical debility and immobility.
It is to avoid such a situation that I, like many others, have been advised by rheumatologists to not skip the prescribed daily dosage and to strictly follow the HCQS regimen for our lifetimes.
My plea as a citizen of India in my early 80s, and on behalf of thousands of other young and old RA-afflicted people, facing a similar dilemma caused by total non-availability of this essential drug is that our government should first dispense its responsibility to its own citizens before exporting the drug to any other country for economic consideration or to uphold its credentials as a ‘responsible country’.
If along with measured stockpiling, it could address the need of the hour by ensuring availability of the much needed drug primarily to healthcare workers and patients, and can simultaneously help stock the shelves of pharmacies, it would be of great help, especially to senior citizens like me, who are not only patients of RA but also the caregivers of their elderly spouses. Deteriorating health of a home-based RA-affected person, will in truth affect two or more lives and the citizens’ right to basic healthcare.