Last week, the first consignment of half a million tablets of hydroxychloroquine – a donation from the government of India – arrived in Mauritius on an Air India flight. Endorsed by China, Brazil and other countries, hydroxychloroquine is also being widely used in the US as a possible treatment for the Covid-19 virus. But what do experts say about the efficiency of the drug in treating the virus?

According to the Indian high commissioner in Mauritius, Tanmaya Lal, Mauritius is one of the first few countries to receive supplies of hydroxychloroquine after a special exemption was granted to ship the medicine to a few countries. India is the largest producer of hydroxychloroquine, a medicine that is used to prevent and treat acute attacks of malaria and treat systemic lupus erythematosus and rheumatoid arthritis in patients whose symptoms have not improved with other treatments. 

The medicine has also been added to the Chinese guidance for the management of the Covid-19 virus, and it has been publicly endorsed by US President Donald Trump since March. Following the increase in demand for the medicine, India emerged as the first responder to the current global crisis by supplying these drugs to several countries, including Mauritius, Spain, Germany, Afghanistan, Bangladesh, Myanmar, Nepal, Sri Lanka and several African countries.The first consignment of the donation to Mauritius included 500,000 tablets of hydroxychloroquine and 12 tonnes of other essential medicines. The consignment was sent to both Mauritius and Seychelles by an Air India Special Charter flight from Delhi last week, following a request from the Mauritian government. The next consignment of these medicines will arrive in the next few weeks. 

“Trump’s backing and optimistic statements – or rather aggressive advocacy – about hydroxychloroquine has no doubt largely contributed to the global hype around the drug.”

Hydroxychloroquine has been strongly promoted by Trump during the last few weeks. Not only has he “heard great things” about the malaria drug, but he also believes that it could be a “game-changer” in the fight against the Covid-19 virus. Faced with a mounting death toll, Trump also vowed to make the affordable medication widely available to fight the pandemic, despite the fact that so far, there has been no conclusive evidence to support the use of the drug as a treatment for Covid-19.In fact, after India first banned the export of pharmaceuticals amid the coronavirus pandemic, Trump  threatened to retaliate against the country if it refused to ship the anti-malaria drug to the US But India finally changed its mind and announced a change in its policy to facilitate the supply of critical drugs to all countries, including the US. 

Trump’s backing and optimistic statements – or rather aggressive advocacy – about hydroxychloroquine has no doubt largely contributed to the global hype around the drug, including in Spain, Brazil, Germany, and also prompted the Mauritian government to ask for the medicine. In addition, the demand increased even further after a recent small-scale French study published in the International Journal of Antimicrobial Agents discovered that the hydroxychloroquine treatment is “significantly associated with viral load reduction/disappearance in Covid-19 patients and its effect is reinforced by azithromycin”.

However, the French study also faced a lot of criticism a few days after its publication. In fact, it was under so much fire that the International Journal of Antimicrobial Agents decided to review the study again and wrote that “a correction to the scientific record may be considered”. One of the reasons the study was criticised is because it failed to take into account patients who had taken the drug and coped poorly.

Moreover, many physicians, including Trump's own adviser and one of the top infectious disease expert in the US, Dr. Anthony Fauci, have also emphasised  the importance of studying drugs in clinical trials before using them for any type of treatment. In the US, at least 15 research centres are currently analysing the effectiveness of hydroxychloroquine as a potential treatment  for the Covid-19 virus.  However, according to these research centres, CNN reported, it would take months to get the study results, and not days as Trump claimed. 

Speaking to the press, Dr. Jeffrey Sparks, a rheumatologist at Brigham at the Harvard Medical School, also stated that while hydroxychloroquine is generally considered safe, the drug also has potential side effects which include severe rashes, dangerous allergic reactions and changes in heart rhythm, which can lead to sudden death. “I think it's too early to really endorse its wide use. I would not endorse it myself,” he said. 

Xavier de Lamballerie and Franck Touret, two doctors who wrote a report in the Antiviral Research journal, wouldn’t endorse it either. In fact, they said, even though the side effects of hydroxychloroquine are generally mild and transitory, “the margin between the therapeutic and toxic dose is narrow”. 
On his side, the leader of the opposition in Mauritius, Arvin Boolell, strongly encouraged strict medical supervision of patients who are given hydroxychloroquine as a treatment for the Covid-19 virus. 

“The use of this drug is very controversial, and it should be used very carefully and diligently. So far, there have been no studies that prove that it can prevent or cure Covid-19. There have been a few generic studies, but they showed that hydroxychloroquine has only a 30 to 40 per cent success rate,” Boolell told Weekly. “Many people have also died of cardiac arrest from using this drug, so it can’t be used on everyone. Patients who are given this medicine should be monitored very, very closely.”

While there is a chance that hydroxychloroquine proves to be effective in treating some cases of the Covid-19 virus, there is also a chance for the risk benefit to backfire and cause more harm than good in the meantime. It looks like Mauritius is among the few countries willing to take that risk.