India, the world's main supplier of generic drugs, has restricted the export of 26 pharmaceutical ingredients and the medicines made from them, including paracetamol, as the coronavirus outbreak plays havoc with supply chains.
Indian drug makers rely on China, the source of the virus outbreak, for almost 70 percent of the active pharmaceutical ingredients (APIs) for their medicines.
Pharmacies have also been warned not to engage in price gouging, and there are reports of the cost of face masks increasing.
Pictures: COVID-19 outbreak around the world
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People wearing face masks cross a road in Shanghai, China, on March 2.
A paramedic wearing a protective suit sanitizes the hands of people in Ashkelon, Israel, on March 2.
Personnel from the health ministry check tourists' temperatures and for any symptoms at the Rumichaca border bridge in Tulcán, Ecuador, on March 1.
A South Korean soldier wearing protective gear sanitizes a street in front of the city hall in Daegu on March 2.
Students of Hanoi National University of Education attend the first day of classes after returning to the university, which was closed for over a month due to the coronavirus outbreak, in Hanoi, Vietnam, on March 2.
U.S. President Donald Trump speaks during a news conference on the coronavirus outbreak as (L-R) U.S. Secretary of Health and Human Services Alex Azar, National Institute of Allergy and Infectious Diseases Director Anthony Fauci, U.S. Vice President Mike Pence, Director of the Centers for Disease Control and Prevention Robert Redfield and U.S. Surgeon General Jerome Adams look on, at the White House on Feb. 29.
Pedestrians wearing face masks cross a square in Tehran, Iran, on Feb. 29.
A police officer wears a protective face mask on the street in Mexico City, Mexico, on Feb. 29.
A member of the Iraqi security forces wears a protective face mask in Baghdad on Feb. 29.
A researcher works in a lab that is developing testing for the COVID-19 at the Hackensack Meridian Health Center for Discovery and Innovation in Nutley, New Jersey, U.S., on Feb 28. The facility develops novel therapies for some of the worlds most difficult diseases.
A health worker takes part in a drill to handle suspected carriers of coronavirus, at a hotel in Guatemala City, Guatemala, on Feb. 26.
Personnel wearing protective gear spray anti-septic solution at a traditional market in Seoul on Feb. 26.
Spanish police officers patrol outside the H10 Costa Adeje Palace hotel in Tenerife, Canary Island, Spain, on Feb. 25.
South Korean President Moon Jae-in talks during a special government meeting to discuss measures to prevent the further spread of COVID-19, at the Daegu City Hall in Daegu on Feb. 25.
Fans wear masks at Stadio San Paolo in Naples, Italy, on Feb. 25, prior to the UEFA Champions League round of 16 first leg match between SSC Napoli and FC Barcelona.
A newly wed couple wear protective masks as they take photos with family in Hong Kong on Feb. 24.
Two men ride a bike as they wear protective masks in Najaf, Iraq, on Feb. 24.
Bruce Aylward of the World Health Organization (WHO) attends a news conference on the WHO-China Joint Mission on coronavirus in Beijing, on Feb. 24.
U.N. Secretary General António Guterres speaks during an update on the situation at the WHO headquarters in Geneva, on Feb. 24.
A street vendor sells face masks outside a railway station in Milan, Italy, on Feb. 24.
Figures depicting coronavirus and "carnevals-virus" are seen at the Shrove Monday celebrations in Düsseldorf, Germany, on Feb. 24.
A reveler wears protective face mask at the Venice Carnival, the last days of which were called off after third death was reported in the country, in Italy on Feb. 23.
Media personnel chase after a passenger (C) who disembarked from the Diamond Princess cruise ship at the Daikoku Pier Cruise Terminal in Yokohama, on Feb. 19.
Indians who were airlifted from Wuhan wait to collect their release certificates before leaving the ITBP quarantine facility in New Delhi, India, on Feb. 17.
Military medics stand in a formation after deplaning from a transport aircraft of the People's Liberation Army Air Force (PLAAF) at the Tianhe International Airport in Wuhan, China, on Feb. 17.
A teacher gives a lecture with the help of her smart phone during an online class at a middle school in Donghai, China, on Feb. 17.
Pictures of Pakistani students studying in Wuhan, China, are displayed by their family members during a demonstration in Lahore, Pakistan, on Feb. 16. The family members are demanding the evacuation of their relatives.
A U.S. passenger gives a thumbs up to reporters while arriving at the Haneda Airport in Tokyo, Japan, on Feb. 17, after disembarking in Yokohama from the Diamond Princess cruise ship.
Nepalese nationals who were in Wuhan walk out from a Nepal Airlines plane at Tribhuvan International Airport in Kathmandu, on Feb. 16. The chartered plane brought back 175 nationals from Hubei province.
A classroom is cleaned in preparation for students' return to school in Hanoi, Vietnam, on Feb. 15.
A woman is seen wearing a protective mask as she holds a rose on Valentine's Day, while waiting for the subway at a station during rush hour in Beijing, on Feb. 14.
An employee receives payment from a customer through a container on a stick, in Beijing on Feb. 12. A ramp has also been set up to deliver food from the counter.
A laboratory technician helps a colleague remove the protective suit after leaving a laboratory in Shenyang, China, on Feb. 12.
Members of the media stand near the cruise ship Diamond Princess, where dozens of passengers were tested positive for coronavirus, at Daikoku Pier Cruise Terminal in Yokohama on Feb. 11.
A Malaysian Royal Guard wears a protective mask as he stands guard outside National Palace in Kuala Lumpur, Malaysia, on Feb. 10.
Workers produce protective clothing at a factory in Wuxi, China, on Feb. 8. The factory, which previously produced suits and sportswear, switched to production of protective clothing as demand increased due to the ongoing coronavirus outbreak.
A Hindu devotee wears a mask as she carries a milk pot on her head at a shrine in Batu Caves during the Thaipusam festival in Kuala Lumpur on Feb. 8.
Hong Kong Chief Executive Carrie Lam speaks to the media during a press conference on the coronavirus situation in Hong Kong on Feb. 8. Lam said that the government has bought 48 million masks and received 17 million more from China to counter the shortage of masks in Hong Kong.
South Korean Prime Minister Chung Sye-kyun has his temperature checked during a visit to a clinic in Gyeonggi, South Korea, on Feb. 8.
Flight attendants wearing protective clothing and masks serve snacks to Canadians, who had been evacuated from China due to the outbreak of novel Coronavirus on an American charter plane, on another aircraft taking them to Canadian Forces Base (CFB) Trenton from the Vancouver International Airport in Richmond, Canada, on Feb. 7.
Workers in protective gear are seen on Japan Coast Guard boats in Yokohama, on Feb. 5, bringing patients from the quarantined Diamond Princess cruise ship.
Beds are set up at an exhibition center, which was converted into a hospital, in Wuhan on Feb. 4.
This handout photo released by Malaysia's Ministry of Health shows citizens being directed onto a bus by health officials as they arrive at the Kuala Lumpur International Airport in Malaysia in Feb. 4.
Members of the Association for Sri Lanka and China Social and Cultural Cooperation (ASLCSCC) hold candles during a vigil to pray for people who are suffering from coronavirus across the world, in Colombo, Sri Lanka, on Feb. 1.
(L-R) Sabine Hagenauer of the infection department at the 4th medical department of Kaiser Franz Josef Hospital, Michael Binder, medical director of the Vienna Hospital Association, and Judith Aberle of the department of virology, Medical University Vienna, address a press conference at Kaiser-Franz-Josef hospital in Vienna, Austria, on Jan. 26. A Chinese flight attendant was quarantined in the hospital with symptoms of flu, in what authorities suspected as the first coronavirus case in the country.
Dozens of diggers work to build a new hospital in Wuhan, on Jan. 25. Due to the large number of infected people, the government decided to establish a temporary 1,000-bed hospital.
Industry experts said they were likely to face shortages if the epidemic drags on.
"Export of specified APIs and formulations made from these APIs … is hereby 'restricted' with immediate effect and till further orders," the Director General of Foreign Trade said in a statement on Tuesday (local time), without explaining the extent of the restrictions.
The government's list of 26 APIs and medicines accounts for 10 percent of all Indian pharmaceutical exports and includes several antibiotics, such as tinidazole and erythromycin, the hormone progesterone and vitamin B12 as well as the common pain killer paracetamol.
"Irrespective of the ban, some of these molecules may face shortages for the next couple of months," Dinesh Dua, chairman of the Pharmaceuticals Export Promotion Council of India, said.
"If coronavirus is not contained, then in that case there could be acute shortages," Mr Dua said.
What is the global impact?
The Indian Government — which has so far confirmed 28 cases of the coronavirus, including 16 Italian travellers — urged calm and said there were enough stocks to manufacture formulations for two to three months.
It was unclear how the restriction would impact the availability of these medicines in the countries that import from India and also depend on China.
In the United States, for instance, Indian imports accounted for 24 percent of medicines and 31 percent of medicine ingredients in 2018, according to the US Food and Drug Administration (FDA).
FDA commissioner Stephen Hahn told US senators on Tuesday the agency is working to determine how the restrictions will affect the US medical supply and the effect on essential medicines.
The FDA last week announced the first coronavirus-related drug shortage in the United States but declined to name the drug in question.
Mr Hahn said on Tuesday the drug was in shortage because of a lack of materials needed to make the API.
Mr Dua said Europe was "panicking".
"I am getting a huge number of calls from Europe because it is very sizeably dependent on Indian formulations and we control almost 26 percent of the European formulations in the generic space," he said.
The World Health Organisation (WHO) announced it was setting up a group to look at further repercussions in the market.
"At the moment, it's not as restrictive as we see right now with personal protective equipment, but the fear is that the ripple effects will make shortages in those medicines as well," head of WHO operations support and logistics Paul Molinaro said.
In a statement, the Indian federal Government said state authorities had been asked to monitor the production and availability of APIs and formulations to prevent black marketing and hoarding.
ABC/Reuters
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