International Trade on Medicines
Priyanshi Agrawal 1933360
Christ (Deemed to be University)
The paper discusses about the disruption caused by health crisis of
COVID-19 in health sector and imbalances in global supply chain of medicines.
It aims to state the measures taken by different nations and pharmaceutical
companies for medicine for international trade of machine. Further, it outlines
the carelessness of international organizations in controlling the worldwide
health crisis.
Keywords: globalization, COVID-19, pharmaceutical companies, drugs.
Over past eight months, havoc created by the pandemic COVID-19 or
Coronavirus Disease 2019 has affected nearly every corner of the world and
almost all sectors of the economy. COVID-19 is a disease caused by newly
discovered SARS-COV2 which causes respiratory illness. Its effects can be
ranged from mild to severe symptoms with old people and people with co-morbidities
being affected the most (WHO). This Communicable Disease’s R naught value is
very high resulting in high number of affected populations. It has affected
almost 1.78 crore people and more than 6.84 lakh deaths worldwide. The pandemic
has completely disrupted social and economic environment. Though governments of
many countries are trying to control its spread by lockdown, increased tracing
and testing, number of cases worldwide are rising at an alarming rate. Many
countries which were infected at beginning of the pandemic, were remarkably
successful to control the disease spread, but the disease has not completely
vanished in those nations. Moreover, lately infected countries at present have reached
their peak in recording the number of active cases and death. Moreover, it is
noticed that developed countries which are more globalized recorded higher
number of cases than less globalized economy.
As the pandemic is expanding at a progressive rate, its impact is
clearly visible on international trade of various goods, mainly on
pharmaceutical gods and medical products like instruments, medicines,
diagnostic apparatus. Sudden outbreak of the pandemic has led to
shortage of medical products, affecting its global supply chain. It has forced
many countries to adapt the policy of protectionism wherein countries banned
export of medical products to fulfill the domestic medical demand in their home
country. This reduced supply of medical products has increased its price due to
levying of tariffs and customs duties.
The supply shock in COVID-19 crisis has surged the hazard posed by international trade of fake medicinal products. Large amount of fake pharmaceutical products due to shortage of COVID-19 drug, is occupying medical trade in developing nations which have poor research and development and medical infrastructure. Unhygienic environment at PPE production sites, imitated hand sanitizers, absence of API in medicines and false coronavirus tests has further worsened the situation. Since the outbreak first originated in China, the country became the largest export of medical supplies. However, fake quality PPE kits sent abroad by China were reported by many nations and later it had to alter its production technique.
Enforcement of lockdown, physical and social distancing
and proper hygiene is observed as the best possible way to contain the
outbreak. This worldwide lockdown has halted many economic activities though
sectors for production of essential commodities are given full freedom.
Millions of people lost their jobs due to declining profits of the companies
which also disrupted global supply chain in the lockdown period. On 23rd
April, 2020 nearly 80 countries had put export ban on foodstuffs, medical equipment,
PPE kits, medical supplies and medicines. These nations have violated the WTO 2012
decision of Agreement on Trade Facilitation on any new export restrictions.
Only 39 out of 80 countries has notified WTO for restrictions (Tirkey, 2020). This
shows the inability and poor strategy of WTO and WHO to control the outbreak
and poor management of these organizations to maintain healthy trade relations
between nations.
Pharma companies have integrated technology with medical
science for formulating effective drugs to overcome the outbreak and analyzing
the potential of existing pharmaceuticals. For instance, many drug companies
have chosen online platforms like 1mg, Pharmeasy.com, Netmeds.com, Amazon Web
Services to transform manufacturing and supply chains for smooth delivery of
the drugs to remote areas. The drug companies have gained deep biotechnological
knowledge from decades of major viral outbreaks like, Nipah virus, Ebola virus,
MERS virus, HIV virus, influenza virus H1N1 and many more. Government has also
incentivized medicine and vaccine development by providing financial to
pharmaceutical companies. For instance, US government will pay $2.1 billion to Sanofi
and GlaxoSmithKline and $1.95 billion to Pfizer and BioNTech for vaccine
development for around 200 million doses collectively.
Colored version of electron microscopy of SARS-COV2. Source: erc.europa.eu
Though there is no solid data to prove efficacy of
these drugs, most countries have authorized the drug for “emergency-use” or as
an “off-label” drug during the pandemic. The drugs which have been used
worldwide are Remdesivir, Lopinavir-Ritonavir, hydroxychloroquine, dexamethasone
and plasma therapy (not a drug), has shown improved results. Remdesivir,
a broad-spectrum antiviral drug developed by Gilead Sciences has shown
effective results for treating viral disease like SARS, MERS, Ebola virus,
Hepatitis C has shown favorable results for fighting COVID-19 (NIH, 2020). It
has been manufactured by several pharma companies under different brand names
and has been approved for its emergency usage in worst-hit regions like US, EU,
India, France, Australia. As Remdesivir is a drug patented by Gilead Sciences, the
company has been charging highly exploitative prices in other countries for its
sale at US$3200 for 6-day treatment against its manufacturing cost of just
US$6. Hydroxychloroquine, an anti-malarial drug along with macrolide has
shown limited but debated results (Mehra, Desai, Ruschitzka, Patel, 2020).
India, the 3rd largest country in the volume of drug production was
the 1st country to approve the combined drug treatment for curing
the disease. India has exported 285 million tablets of the drug to 40 countries
and has gifted $5 million of drugs to import-reliant countries till date.
However, the drug was put on ban on export to developed countries so that India
has enough availability of drugs to cure its own patients. The country had also
put ban on export of 26 pharmaceutical ingredients and formulation for
manufacturing generic drugs. Similarly,
lopinavir- ritonavir and dexamethasone which can cure mild and severe symptoms
patients have shown recovery. Plasma therapy, most successful in early
treatment of the disease has proven to be one of the best methods for treating
the disease.
Pharma companies and
medicine trade-
§ Boehringer
Ingelheim- A German pharmaceutical company, has a growing team of more than 100
scientist from nearly all areas of R&D for finding effective treatment
solutions for COVID-19. It has received collaboration call by Innovative
Medicines Initiatives (IMI) of the EU and Bill & Melinda Gates Foundation
for COVID-19 medicine development. It also supports international development
of medicines by its open innovation portal opn.Me.com, where anti-viral
compounds and high-quality pharmaceutical tools are offered for free pre-clinical
testing of research.
§ Johnson
& Johnson-An American multinational conglomerate, is doing research to find
new chemical compounds with antiviral response against COVID-19 in
collaboration with Rega Institute of Medical Research (Belgium).
§ Novartis-
Along with new R&D in medicine for COVID-19, it is speedily testing its
existing treatment solutions for checking its efficacy against treating the
disease. It aims to volunteer 450 patients at multiple medical countries in
France, Germany, UK, US and Spain.
§ AstraZeneca
– This company is focusing on SOLIDARITY Trial of WHO to find an effective and
universally accessible treatment for COVID-19 by evaluating the treatment of
antibody generation. It has also collaborated with AIIMS, Delhi (India) and
Sweden for digital, affordable, quality and accessible healthcare to the large
chunk of population (ABPI, 2020).
These are some of the pharma companies which are
collaborating globally for finding quick treatment for COVID-19 through intense
R&D. There are four classification of SARS-COV2 based on the strands, 229E (alpha coronavirus, NL63 (alpha coronavirus), OC43 (beta coronavirus), HKU1 (beta coronavirus), and nearly 2000
genetic sequences of viruses, which are scattered randomly in different parts
of the world (CDC, 2020).
This
different classification of virus is further complicating the medicine
development to which all the patients can equally access. Since, coronavirus
can be infected both symptomatic and asymptomatic with its effect ranging from
mild to severe, the specific and proven medicine for curing the disease has
further increased complexity for R&D of the medicines. Intensive research,
training, adequate fund allocation and government support to the health
institutions is the need of the hour. The health crisis has also forced
government and public health sector to increase expenditure of GDP to improve
health sector in their respective nations. Currently, around 150 countries
are in the process of developing vaccines for containing COVID-19 pandemic. The
pandemic has so critical effects that even non-COVID patients like those
suffering from NCD like cancer, diabetes, cardiovascular disease are hesitating
to visit the hospitals for getting their health treatment and they are not
receiving medical service for the same in especially developing countries due
to shift of hospital’s focus to COVID-19 treatment. Fear, panic and anxiety are
further affecting the mental health of these patients.
References
The
Association of British Pharmaceutical Industry (ABPI)(2020, June 8). What are
pharmaceutical companies doing to tackle COVID-19? Retrieved from:https://www.abpi.org.uk/medicine-discovery/covid-19/what-are-pharmaceutical-companies-doing-to-tackle-the-disease/
Mehra, M.D., Desai, S.S, Ruschitzka, F,
Patel, A.N. (2020, May 22). Hydroxychloroquine or chloroquine with or without
a macrolide for treatment of COVID-19? The lancet. DOI:
https://doi.org/10.1016/S0140-6736(20)31180-6
Centers for Disease Control and Prevention
(2020, February 15). National Center for Immunization and Respiratory Disease
(NCIRD), Division of Viral Disease. Retrieved from: https://www.cdc.gov/coronavirus/types.html
Tirkey, A (2020, May 23). COVID-19:
Export bans, trade rules and international cooperation. orfonline.org.
Retrieved from: https://www.orfonline.org/expert-speak/covid19-export-bans-trade-rules-international-cooperation
National Institute of Health (NIH) (2020,
February 25). NIH trial of Remdesivir to treat COVID-19 begins. nih.gov.
Retrieved from: https://www.nih.gov/news-events/news-releases/nih-clinical-trial-remdesivir-treat-covid-19-begins
erc.europa.eu (2020, March 15). Retrieved
from https://erc.europa.eu/news-events/magazine/coronavirus-what-s-beyond-science-frontier
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