Dexamethasone: UK government condemned for ‘morally questionable’ export restriction on life-saving coronavirus drug

Health campaigners warn against dangers of countries turning inwards during time of unprecedented crisis and hoarding essential medicine 

Samuel Lovett
Thursday 18 June 2020 07:09 BST
What is dexamethasone, how does it work and when will it be used?

Health campaigners have condemned the “morally questionable” and “self-defeating” decision of the government to place export restrictions on dexamethasone, after the drug was shown to reduce the risk of death by up to one-third among severely ill coronavirus patients.

The Department for Health and Social Care announced on Tuesday that dexamethasone, a cheap and widely available anti-inflammatory drug, had been approved to treat all UK hospitalised patients requiring oxygen, including those on ventilators.

This followed the publication of preliminary data by Oxford University which showed the steroid’s potential to lower the mortality rate of Covid-19, reducing deaths by one-fifth in patients on oxygen feeds and by one-third in those who needed a ventilator to breathe.

The government has stockpiled 240,000 courses of dexamethasone since March, and it later emerged that oral and injection solutions for the drug had been placed on a list of medicines banned for export from the UK at midnight on Tuesday. The export of tablets has been restricted since April.

The DHSC said the ban only applied to exports of drugs meant to remain in the UK, and was designed to deter companies from buying domestic supplies of the drug and reselling them at higher prices abroad, otherwise known as parallel exporting.

However, the decision has drawn widespread criticism from campaigners within the health sector, who have repeatedly warned against the dangers of governments turning inwards at a time of global crisis, while the German health ministry notably insisted there is no reason to stockpile the drug.

Global Justice Now, which campaigns on issues of trade, health care and justice in the developing world, said that “nationalistic hoarding of effective Covid19 treatments should have no place in a global pandemic”.

Heidi Chow, a senior policy manager, told The Independent: “Restricting the export of this inexpensive drug could prove fatal for the poorest and most vulnerable communities in the world and could also trigger further export restrictions by other rich countries.

“This UK-first approach is not just morally questionable, but it is hugely self-defeating as we can only end this crisis if we act in global solidarity and work collectively to ensure those in need everywhere have access to the most effective treatments.”

Médecins Sans Frontières called on the UK government to release the full trial results, so “we can be confident this drug is an effective treatment,” and insisted that frontline healthcare workers around the world need to be prioritised in receiving medicine that is proven to work.

“Any treatment for COVID-19 should be treated as a global public good,” Roz Scourse, a research and policy officer at MSF, told The Independent.

“Treatments should be equitably allocated based on global need and not hoarded or controlled by individual countries.”

Several senior US doctors have expressed scepticism over the findings, and also asked for the results to be published in full.

Dr Thomas McGinn, deputy physician-in-chief at New York’s largest healthcare system, Northwell Health, said: “I’ll just wait to see the real data, see if it’s peer reviewed and gets published in a real journal.”

The UK government, along with the US, has already distanced itself from the World Health Organisation’s voluntary technology “pool”, which encourages governments and pharmaceutical groups to share data, intellectual property and manufacturing know-how in order to accelerate the development of treatments against Covid-19 – and Ms Scourse said the decision to ban exports on dexamethasone marked another “step in the wrong direction” for Downing Street.

“​An export ban contradicts previous statements by the UK government on the need for a global response to the pandemic and the global equitable allocation of treatments and vaccines,” she added.

“We need to be improving transparency and coordination among and between governments, not reducing it. Inward-looking nationalistic moves such as this are becoming the norm in the UK and beyond, and they will only risk prolonging the pandemic.”

STOPAIDS, a network of agencies working together to secure an effective global response to HIV and AIDS, said the government had “disregarded” OECD guidance to avoid export restrictions during the pandemic.

James Cole, an advocacy officer, told The Independent: “Introducing more and more export restrictions puts up barriers to achieving the international collaboration and solidarity needed to ensure everyone has equitable and timely access to Covid-19 treatments they need and any future vaccine.

“Without this, there may be starkly unequal distribution, which could have a dire impact on the NHS as well as developing world countries. A recent YouGov poll found the UK public overwhelmingly support equitable global access to Covid-19 vaccines and treatments. I hope the Prime Minister takes note and urgently takes this vital drug off the export ban.”

Health secretary Matt Hancock said dexamethasone “is not by any means a cure but it is the best news we have had”.

“It’s the first time that anyone in the world has clinically proven that a drug can improve the survival chances of the most seriously ill coronavirus patients,” he told the House of Commons on Wednesday.

A spokesperson for the DHSC told The Independent: “We have not banned exports from the UK of medicines intended for other countries’ markets.

“We have banned the ‘parallel export’ of certain medicines, including potential coronavirus treatments and drugs commonly used in intensive care, to help ensure the uninterrupted supply for NHS patients.

“We’re backing efforts in the UK to develop treatments to beat Covid-19 and banning parallel exports helps ensure we can get any potential lifesaving treatment to those who need it. If medicines in the UK may be needed by our patients they should not be diverted to other countries for financial gain.”

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