Under threat of "retaliation" from President Trump, India earlier this week reversed its export restrictions and some companies are ramping up production of a malaria drug Trump has touted as a potential game-changer for fighting COVID-19.
Medical experts including the National Institutes of Health's Dr. Anthony Fauci have warned that there is no clinical evidence that hydroxychloroquine (HCQ) is an effective COVID-19 treatment. Clinical trials have only recently begun.
"We are only meeting the demand," Vikas Swarup, an Indian foreign ministry official, told reporters Thursday. "It is entirely up to the receiving countries what they want to do with the HCQ they import from India."
The drug is proven to treat malaria, rheumatoid arthritis and lupus. It was among 24 medicines, including the painkiller acetaminophen, for which India restricted exports on March 25, as the country went into lockdown.
Officials said they wanted to ensure domestic supplies. India is the world's biggest generic drug maker, and it manufactures most of the global supply of hydroxychloroquine.
The U.S. had already placed orders for hydroxychloroquine at the time when the exports were restricted. When Trump learned those might not be fulfilled, he phoned Indian Prime Minister Narendra Modi on Sunday.
"I said, 'We'd appreciate your allowing our supply to come out," Trump told reporters on Monday. "If [Modi] doesn't allow it to come out, that would be O.K. But of course, there may be retaliation. Why wouldn't there be?"
A day later, on Tuesday, the Indian government announced a reversal, saying it had ensured adequate supplies for Indians and would allow limited exports of hydroxychloroquine. The reversal applies to neighboring countries and others hard-hit by the virus, a spokesman said.
"We all heard Trump's statement, where he's seen to be making a not-so-subtle threat to India," says Sunetra Choudhury, political editor of the Hindustan Times.
Just six weeks ago, Trump was making his first official visit to India, hugging Modi onstage at a rally with 100,000 people.
"The timing and the context of Trump being in India, and India really laying out the red carpet — all of it together makes it a political controversy," Choudhury told NPR, referring to Trump's statement about retaliation.
Opposition leaders accuse Modi of caving into U.S. pressure. "Friendship isn't about retaliation," tweeted Rahul Gandhi, leader of the Indian National Congress party.
The Indian government insists its reversal had nothing to do with Trump's call. In a text message to NPR, government spokesman Anurag Srivastava called it a "humanitarian" gesture. India is supplying "essential drugs to some nations who have been particularly badly affected by the pandemic," he wrote.
There have been nearly 15,000 coronavirus deaths in the U.S., and fewer than 200 reported in India.
NPR producer Sushmita Pathak contributed to this report from Mumbai.