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Wednesday, April 8, 2020

Pronounce - Hydroxychloroquine; Brazil President invokes Lord Hanuman Sanjeevini

Brazil  is the largest country in both South America and Latin America. Brazil is the world's fifth-largest country by area and the sixth most populous. Its capital is Brasília, and its most populous city is São Paulo. The federation is composed of the union of the 26 states, the Federal District, and the 5,570 municipalities. It is the largest country to have Portuguese as an official language and the only one in the Americas.  Sadly, Brazil is the epicenter of the new SARS coronavirus in Latin America. No country has more cases, now standing at 14,034 as of April 7. To make matters worse, no country in South America is least prepared for the outbreak, at least as measured by BNP Paribas in a report released on Tuesday.

It’s not because Brazil’s President Jair Bolsonaro downplayed the coronavirus. The country is in quarantine, having done it around the same time as the U.S. as governors took action per recommendations of Bolsonaro’s own Public Health Secretary.

Hydroxychloroquine (HCQ), sold under the brand name Plaquenil among others, is a medication used to prevent and treat malaria in areas where malaria remains sensitive to chloroquine.  Other uses include treatment of rheumatoid arthritis, lupus, and porphyria cutanea tarda.  It is taken by mouth.  Hydroxychloroquine is in the antimalarial and 4-aminoquinoline families of medication.   It is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system.  India is emerging as a top exporter of medicines.

Military police are now a fixture outside São Paulo governor João Doria’s home in the city’s tree-lined Jardins neighbourhood. Since last week, the leader of Brazil’s largest and wealthiest state has received death threats after he publicly criticised President Jair Bolsonaro’s flouting of international health guidelines on self-isolation and social distancing. The stand-off between the two men is just one flashpoint in a growing conflict between the populist leader and Brazil’s political establishment, most notably influential state governors, over how to respond to the coronavirus crisis, which has already claimed the lives of 550 citizens.

A quick search revealed some conflict in Apr 2001, when India was requesting consultations with Brazil concerning-    the determination by the Brazilian government to continue to impose anti-dumping duties on jute bags and bags made of jute yarn from India, and its  refusal to reconsider the decision to continue anti-dumping duties on Indian jute products despite the fact that the non-existence of that company was brought to the notice of the authorities.  Life and more importantly Government at the Centre has changed !

The epicenter of the coronavirus outbreak in Latin America, Brazil's Sao Paulo state, has said it expects 111,000 deaths in the next six months, and extended its stay-at-home measures another two weeks. The forecast -- an official projection, the state government said -- would appear to put Brazil on track to become one of the worst-hit countries in the world.  Sao Paulo, the teeming industrial hub where the new coronavirus first appeared in Latin America, has confirmed 4,620 cases and 275 deaths so far.  Governor Joao Doria, who closed non-essential businesses on March 24 and advised people to stay home, said containment measures would be needed for at least two more weeks or the situation would get far worse. Police are already authorised to break up crowds by force if necessary, he said.

Hydroxychloroquine, the anti-malarial drug that US President Donald Trump touts as cure for coronavirus patients, has become one the most sought after drugs worldwide. However, it's India that has seen itself caught in the middle of this heightened demand. After some media touted America's threat of 'retaliation', Brazil has now invoked Ramayana to request New Delhi it's export.  "Just as Lord Hanuman brought the holy medicine from the Himalayas to save the life of Lord Rama's brother Laksmana, and Jesus healed those who were sick and restored the sight to Bartimeu, India and Brazil will overcome this global crisis by joining forces and sharing blessings for the sake of all peoples. Please accept, your Excellency, the assurances of my highest esteem and consideration," read the letter from President Jair Bolsonaro to Prime Minister Narendra Modi, reports almost all mainline media now.

The government had put a hold on exports of hydroxychloroquine as well as on the pain reliever, paracetamol, saying stocks were depleting because of the hit to global supply chains after the coronavirus emerged in China late last year. But Trump spoke to PM Modi over the weekend seeking supplies.  India's neighbours, including Nepal, have also sought the anti-malaria drug.  Foreign ministry spokesman Anurag Srivastava said, "It has been decided that India would licence paracetamol and HCQ in appropriate quantities to all our neighbouring countries who are dependent on our capabilities." "We will also be supplying these essential drugs to some nations who have been particularly badly affected by the pandemic," he said.

US President Donald Trump did a u-turn a day after suggesting retaliation against India by praising Delhi and pointed out that Prime Minister Narendra Modi was helpful as he backed India’s position on Hydroxychloroquine (HCQ). In what would signal change of course Trump in a telephone interview to Hannity on Fox News said, “I bought millions of doses. More than 29 million. I spoke to PM Modi, a lot of it comes out of India. I asked him if he would release it? He was Great. He was reall .. He was Great. He was really good. You know they put a stop because they wanted it for India. But there is a lot of good things coming from that."

“Given the enormity of the COVID-19 pandemic, India has always maintained that the international community must display strong solidarity and cooperation. This approach also guided our evacuation of nationals of other countries. In view of the humanitarian aspects of the pandemic, it has been decided that India would license paracetamol and HCQ in appropriate quantities to all our neighbouring countries who are dependent on our capabilities. We will also be supplying these essential drugs to some nations who have been particularly badly affected by the pandemic. We would therefore discourage any speculation in this regard or any attempts to politicise the matter,” the note said.

In the absence of a vaccine or a cure for the coronavirus infection, the National Task Force of the Indian Council of Medical Research had recommended the use of HCQ under certain conditions for high-risk persons like health care providers. The drug, according to the ICMR, has been found effective against COVID-19 in laboratory and in-vivo (processes taking place inside a living organism) studies and was approved by the Task Force on March 22 for prophylaxis of high-risk persons. The eligible individuals were, one, asymptomatic health workers involved in the care of suspected or confirmed cases of COVID-19 and, two, asymptomatic household contacts of laboratory symptomatic cases. The drug was not to be given to children under 15 years of age or to persons with known case of retinopathy nor was it to be given over the counter without a medical prescription.

Interesting and by coincidence, Hanumath Jayanthi is celebrated in many parts of the country this day.

With regards – S. Sampathkumar
8th Apr 2020.

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