Uganda’s Cipla takes bold step to make ‘unpopular’ malaria drug

Tuesday May 12 2020

Quality Chemical Industries Uganda drug production line in Kampala. PHOTO | MORGAN MBABAZI


Uganda pharmaceutical firm, Cipla Quality Chemicals Industries Ltd (CiplaQCIL), is taking a big bet in the war against global Covid-19 pandemic.

The Uganda Securities Exchange (USE)-listed company will this month start production of the controversial anti-malarial drug, hydroxychloroquine, targeting Ugandan coronavirus patients and wider African market.

Some health experts have touted hydroxychloroquine as being an effective immune modulator for patients suffering the virus disease, even though there is no consensus yet on its reliability of the drug and side-effects.

“We hope to start manufacture of HCQ in about two weeks, the hydroxychloroquine raw material will be arriving later this week,” said CiplaQCIL chief executive, Nevin Bradford, in an interview with The EastAfrican.

Uganda’s Ministry of Health is Cipla’s primary client, providing an important financial cushioning for the company’s big bet.

The pharmaceutical firm, which last year recorded a turnover of Ush195.1 billion ($50.9 million), down from Ush227.3 billion ($59.3 million) in 2018, is a subsidiary of Cipla India – one of the world’s largest generic drugs manufacturers.


Cipla Ltd of India owns a 51 per cent stake in the Kampala-based drugs processor through its wholly-owned Meditab Holdings Ltd of Mauritius, while a number of other corporate, institutional and individual investors – both Ugandan and foreign – hold the remaining stake.

Mr Bradford said the pharmaceutical firm will initially supply Uganda but will rump up capacity to produce more if there is demand from governments in the region.

The World Health Organisation (WHO) is yet to approve HCQ as part of the treatment regime for Covid-19, but the drug is being used to treat patients in clinical trials in France and China.

President Yoweri Museveni has been a strong advocate of the drug, terming it an effective solution to the Covid-19 challenge in several of his televised addresses to the nation, a position that has earned an endorsement of Uganda’s health professionals.

US President Donald Trump has also strongly backed the controversial drug, despite scepticism of its efficacy by his own health officials.

Uganda’s director general of Health Services Dr Henry Mwebesa said the country’s first lot of patients that recovered from Covid-19 were on HCQ, although Uganda is not among the countries participating in clinical trials for the drug.

“We are using HCQ on compassionate means not as clinical trial,” Dr Mwebesa told The EastAfrican.

In medical jargon, compassionate use is a method of providing experimental treatments even before a drug is given final approval for use in humans; on very sick individuals who have no other treatment options.

Health experts have particularly pointed to HCQ’s harmful side effects, but Cipla said these only manifest after long-term use.

“Covid-19 treatment is short term,” said Mr Bradford, adding that only the Ugandan National Drug Authority can advise on the potential longer term safety concerns.

Since reporting its first case on March 21, Uganda has managed to flatten the curve of coronavirus infections, which currently stand at 98 cases, of whom 55 have recovered and been discharged, with HCQ used in the management of their symptoms.

In one of his televised addresses last month, President Museveni revealed that he had spoken to Indian Prime Minister Narendra Modi to help expedite export of raw material used in the manufacture of hydroxychloroquine, which remains red flagged worldwide especially in Europe where patients developed heart conditions. “India will supply us with the hydroxychloroquine as well as the raw-materials to make it here,” President Museveni said.

Production of the drug locally shows that Uganda has decided to go all out to deploy the treatment regime, despite caution from the WHO scientists and top epidemiologists that HCQ has fatal side effects.

Mr Bradford says the company which supplies anti-malarial drug, Lumarten, and ARVs across the region, has not yet received any orders from other East African countries.

Cipla has a production capacity of 1.56 billion tablets per year, averaging 130 million tablets a month.

Besides the anti-malarial and HIV treatment, it also produces hepatitis B drugs.

The company has signed a deal to supply the South African government with ARVs worth at least $10 million over the next 12 months.

President Museveni maintains that Uganda will use home-grown solutions, including the locally made HCQ, personal protective equipment including masks, scrub suits, goggles, protective glass and gloves as well as hand sanitiser to manage Covid-19. Cipla’s Kampala plant produces drugs for both the local market and export to at least 14 other African countries. The firm’s drugs have the backing of the World Health Organisation and counts the Global Fund as one of its major clients.

The use of hydroxychloroquine has become more pronounced in recent months following the emergence of coronavirus in China in December 2019, but pharmaceutical firms moving into its production envisage a market even when Covid-19 pandemic is controlled.

“Obviously we hope the hydroxychloroquine does not have to [only] be used for Covid. The drug has existing uses in the treatment of arthritis and auto immune conditions: if not required for Covid-19 can be used in these conditions,” said Mr Bradford.