India, the world's main supplier of generic drugs, has restricted the export of 26 pharmaceutical ingredients and the medicines made from them

India will continue to supply vital pharmaceutical ingredients to Israel despite government restrictions curbing drug exports, following a request by Prime Minister Benjamin Netanyahu to his Indian counterpart Narendra Modi.

Health Ministry deputy director-general Prof. Itamar Grotto told Channel 13 on Friday that India has agreed to make an exception and permit exports to Israel, but could not confirm whether a similar request regarding the export of thousands of N95 face masks has been approved.

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, a common pain reliever also sold as acetaminophen, as the Coronavirus pandemic outbreak plays havoc with supply chains.

The government’s list of 26 active pharmaceutical ingredients (APIs) and medicines accounts for 10% of all Indian pharmaceutical exports and includes several antibiotics, such as tinidazole and erythromycin, the hormone progesterone and Vitamin B12.

“An exception has been granted and drug procurement processes are currently being carried out,” Grotto said. “The Indians have agreed to exempt Israel.”

Discussions were continuing between representatives from the Embassy of Israel in New Delhi and government officials, Channel 13 reported.

Grotto dismissed reports of a lack of medical equipment in hospitals, saying that Israel possessed a “large quantity of protective equipment” when considering population size, but was planning to increase supplies.

Indian drug makers rely on China, the source of the coronavirus outbreak, for almost 70% of the APIs for their medicines. Industry experts say they are likely to face shortages if the pandemic continues.

“Export of specified APIs and formulations made from these APIs... is hereby ‘restricted’ with immediate effect and till further orders,” Indian director-general of Foreign Trade, Amit Yadav, said in a statement on March 3, without explaining the extent of the restrictions.

As with other industries, many Chinese drug ingredient makers began reopening last month but transport bottlenecks, shortages of raw materials and staff absences due to quarantines are limiting the amount factories can produce and export, according to manufacturers and industry executives.

“Resuming work does not mean resuming production,” said Chenghao Wu, a manager in the international market department of Zhejiang Guobang Pharmaceutical, an API maker in eastern Zhejiang province.

More so than other industries, evaluating inventory levels in pharmaceutical supply chains is particularly difficult due to limited disclosure by drug makers, manufacturers and healthcare providers.

The drug manufacturing process is also vulnerable to disruption in part because it follows strict rules: factories must produce using processes and amounts of chemicals registered with regulators in the countries where the drugs are sold. A single drug might require 10 or more different materials to produce and may be impossible to make if one is unavailable.