Information plate on counter in pharmacy with text
  • South Africa has banned the export of face masks and hand sanitiser – and the drug hydroxychloroquine.
  • It is not yet clear if the malaria drug is actually useful against Covid-19, but the US just authorised its use in that context.
  • A blood replacement treatment, and some standard vaccinations for diseases such as polio, now also have export protections.
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South Africa now requires a special export permit for anyone who wants to sell face masks or alcohol-based hand sanitiser abroad – and has also banned the foreign sale of hydroxychloroquine, a drug the United States just started using to treat Covid-19.

The export ban is in place until South Africa lifts its state of disaster around the disease.

Hydroxychloroquine sulfate is commonly used to treat arthritis, and prevent or treat malaria. It is classed as well tolerated, and is relatively safe at the correct doses (much safer than chloroquine), though side effects can include stomach pain, nausea, vomiting, and headache.

Its use against the novel coronavirus was famously pushed by US President Donald Trump – despite a lack of clear evidence that it would work. On Sunday the US Federal Drug Administration (FDA) issued an "Emergency Use Authorisation" that now allows hydroxychloroquine sulfate and chloroquine phosphate to be administered in the US, in the treatment of Covid-19 – still without clear evidence of its efficacy.

Under the new rules, in force since Friday, exporters will require special clearance to move any of the drug out of South Africa.

The same applies to human albumin, used to replace blood in trauma cases, and a short list of standard vaccinations for diseases that include polio, rotavirus, and tetanus.

With global supply lines slowed or disrupted – and the chance that a SARS-CoV-2 vaccine may receive priority manufacture once available, the Covid-19 crisis has caused concern about the long-term availability of such vaccines.

Hydroxychloroquine may or may not work against the novel coronavirus

The World Health Organisation (WHO) has taken a careful stance on hydroxychloroquine as a treatment for Covid-19, saying that while it is watching trials, there is currently "insufficient data to assess the efficacy of either of these medicines in treating patients with Covid-19, or in preventing them from contracting the coronavirus."

One trial in the US is looking at using the drug as a post-exposure treatment, to see if it can work as a prophylaxis as sorts for those who have had contact with a SARS-CoV-2 carrier at home, or in a hospital setting.

Smaller studies, on treating patients with active Covid-19, have yielded supposedly promising results, but many important questions remain about those findings – which are only likely to be answered, even in part, in coming months.

South Africa is a participant in one crucial test, the Public Health Emergency Solidarity Trial run by WHO. That trial is also due to examine the possible uses of remdesivir and lopinavir or ritonavir, none of which are subject to the export ban.

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