World Bank lowers India's growth forecast

Jun 4: A malaria drug President Donald Trump took to try to prevent COVID-19 proved ineffective for that in the first large, high-quality study to test it in people in close contact with someone with the disease.

Results published Wednesday by the New England Journal of Medicine show that hydroxychloroquine was no better than placebo pills at preventing illness from the coronavirus.

The drug did not seem to cause serious harm, though -- about 40% on it had side effects, mostly mild stomach problems.

 “We were disappointed. We would have liked for this to work,” said the study leader, Dr. David Boulware, an infectious disease specialist at the University of Minnesota.

“But our objective was to answer the question and to conduct a high-quality study,” because the evidence on the drug so far has been inconclusive, he said.

Hydroxychloroquine and a similar drug, chloroquine, have been the subject of much debate since Trump started promoting them in March.

Hydroxychloroquine has long been used for malaria, lupus, and rheumatoid arthritis, but no large studies have shown it or chloroquine to be safe or effective for much sicker patients with coronavirus, and some studies have suggested the drugs may do harm.

Trump took a two-week course of hydroxychloroquine, along with zinc and Vitamin D, after two staffers tested positive for COVID-19, and had no ill effects, according to results of his latest physical released by his doctor Wednesday.

Federal regulators have warned against hydroxychloroquine's use except in hospitals and formal studies because of the risk of side effects, especially heart rhythm problems.

Boulware's study involved 821 people in the United States and Canada living with someone diagnosed with COVID-19 or at high risk of getting it because of their job -- doctors, nurses, ambulance workers who had significant exposure to a sick patient while not wearing full protective gear.

They were randomly assigned to get either the nutrient folate as a placebo or hydroxychloroquine for five days, starting within four days of their exposure. Neither they nor others involved in the research knew who was getting which pills.

After 14 days in the study, 12 per cent on the drug developed COVID-19 symptoms versus 14 per cent in the placebo group, but the difference is so small it could have occurred by chance, Boulware said.

“There's basically no effect. It does not prevent infection,” he said of the drug. Even if it were to give some slim advantage, “we'd want a much larger effect” to justify its use and risk of side effects for preventing illness, he said.

Results were no different among a subgroup of participants who were taking zinc or vitamin C, which some people believe might help make hydroxychloroquine more effective or fight the coronavirus.

There are some big caveats: The study enrolled people through the Internet and social media, relying on them to report their own symptoms rather than having them tracked in a formal way by doctors.

Participants were not all tested for the coronavirus but were diagnosed as COVID-19 cases based on symptoms in many cases. And not all took their medicines as directed.

The results “are more provocative than definitive,” and the drug may yet have prevention benefits if tried sooner or in a different way, Dr. Myron Cohen of the University of North Carolina at Chapel Hill wrote in a commentary in the journal.

Others were glad to see a study that had a comparison group and good scientific methods after so many weaker reports on hydroxychloroquine.

“This fits with everything else we've seen so far which suggests that it's not beneficial," said Dr. Peter Bach, director of a health policy center at Memorial Sloan Kettering Cancer Center in New York.

This study was in younger relatively healthy people, but the results “would make me very discouraged about trying to use this in older people” who are most vulnerable to serious illness from the coronavirus, Bach said.

“If it does work, it doesn't work very well.” Dr. Dan Culver, a lung specialist at the Cleveland Clinic, said there's still a chance that giving the drug sooner than four days after someone's exposure to the virus may help prevent illness.

But the study “takes 'home run' off the table” as far as hopes for the drug, he said.

The study was mostly funded by David Baszucki, founder of Roblox, a California-based game software company, and other private donors and the Minnesota university.

Boulware also is leading a study testing hydroxychloroquine for treating COVID-19. The study is finished and results are being analyzed now.

On Tuesday, the journal Lancet posted an “expression of concern” about a study it published earlier this month of nearly 15,000 COVID-19 patients on the malaria drugs that tied their use to a higher risk of dying in the hospital or developing a heartbeat problem.

Scientists have raised serious questions about the database used for that study, and its authors have launched an independent audit.

That work had a big impact: the World Health Organization suspended use of hydroxychloroquine in a study it is leading, and French officials stopped the drug's use in hospitals. On Wednesday, the WHO said experts who reviewed safety information decided that its study could resume.

Mar 10: Indian energy tycoon Mukesh Ambani is no longer Asia’s richest man, relinquishing the title to Jack Ma after oil prices collapsed along with global stocks.

The rout, exacerbated by mounting fears that the spread of the novel coronavirus will thrust the world into a recession, erased $5.8 billion from Ambani’s net worth on Monday and pushed him to No. 2 on the list of Asia’s richest people, according to the Bloomberg Billionaires Index. Ma, the Alibaba Group Holding Ltd. founder who relinquished the No. 1 ranking in mid-2018, is back on top with a $44.5 billion fortune, about $2.6 billion more than Ambani.

Oil plunged the most in 29 years on Monday as Saudi Arabia and Russia vowed to pump more in a struggle for market share. The slump comes just as the coronavirus is spurring the first decline in demand in more than a decade. That raises questions about whether Ambani’s flagship Reliance Industries Ltd. will be able to cut net debt to zero by early 2021, as he has pledged. The plan hinges on a proposal to sell a stake in the group’s oil and petrochemicals division to Saudi Arabian Oil Co., the world’s biggest crude producer.

While the coronavirus has curtailed some of tech giant Alibaba’s businesses, the damage has been mitigated by increased demand for its cloud computing services and mobile apps.

Reliance Industries, by comparison, has no such silver lining. The Indian conglomerate’s shares plunged 12% on Monday, the most since 2009, extending this year’s decline to 26%. Alibaba’s American depositary receipts have slipped 6.8% so far in 2020.

Ma reclaims crown after Reliance shares were pummeled in 2020.

Few of the world’s billionaires fared well in Monday’s collapse as the S&P 500 Index and Dow Jones Industrial Average each plunged more than 7.5%, the most since the 2008 financial crisis, threatening to end the longest bull market in history. But no one did worse than those whose fortunes are underpinned by oil. Wildcatter Harold Hamm’s fortune was cut almost in half to $2.4 billion and fellow oil magnate Jeff Hildebrand lost $3 billion, bumping both from Bloomberg’s 500-member wealth ranking.

In a pivot toward new businesses such as telecommunications, technology and retail, Ambani’s Reliance Industries has piled on billions of dollars of debt over the years.

It spent almost $50 billion -- most of it funded by borrowings -- to build Reliance Jio Infocomm Ltd., which became India’s No. 1 wireless carrier within about three years of its debut. As the mobile venture took off, Ambani also unveiled plans for an e-commerce empire to rival Amazon.com Inc. in India.

Addressing concerns over the liabilities, Ambani pledged in August to cut the group’s net debt to zero from about $21 billion as of last March. The Aramco deal is crucial to that plan for which Reliance Industries has valued its oil-to-chemicals division at $75 billion including debt, implying a $15 billion valuation for the 20% stake that’s for sale.

Signs of a potential delay to that deal unnerved some investors, hammering the stock since it touched a record high on Dec. 19.

Reliance Industries expected the Aramco transaction to be completed by March, but people familiar with the matter said in February that talks were still ongoing to bridge differences between the two parties over the deal’s structure.

Adding to the uncertainty, Indian Prime Minister Narendra Modi’s administration has petitioned a court to halt the proposed stake sale, threatening a key source of funds needed to pare net debt.

But Ambani, 62, may soon bounce back from the setback, said Harish H.V., managing partner at ECube Investment Advisors in Bengaluru, India.

“The game isn’t over,” he said. “Ambani has successfully built a robust business model which would keep him in the game. Moreover, his telecom business will start yielding results in coming years.”

Apr 12: India and other South Asian countries are likely to record their worst growth performance in four decades this year due to the coronavirus outbreak, the World Bank said on Sunday.

The South Asian region, comprising eight countries, is likely to show economic growth of 1.8 per cent to 2.8 per cent this year, the World Bank said in its South Asia Economic Focus report, well down from the 6.3 per cent it projected six months ago.

India's economy, the region's biggest, is expected to grow 1.5 per cent to 2.8 per cent in the fiscal year that started on April 1. The World Bank has estimated it will grow 4.8 per cent to 5 per cent in the fiscal year that ended on March 31.

"The green shoots of a rebound that were observable at the end of 2019 have been overtaken by the negative impacts of the global crisis," the World Bank report said.

Other than India, the World Bank forecast that Sri Lanka, Nepal, Bhutan and Bangladesh will also see sharp falls in economic growth.

Three other countries - Pakistan, Afghanistan and the Maldives - are expected to fall into recession, the World Bank said in the report, which was based on country-level data available as of April 7.

Measures taken to counter the coronavirus have disrupted supply chains across South Asia, which has recorded more than 13,000 cases so far - still lower than many parts of the world.

India's lockdown of 1.3 billion people has also left millions out of work, disrupted big and small businesses and forced an exodus of migrant workers from the cities to their homes in villages.

In the event of prolonged and broad national lockdowns, the report warned of a worst-case scenario in which the entire region would experience an economic contraction this year.

To minimize short-term economic pain, the Bank called for countries in the region to announce more fiscal and monetary steps to support unemployed migrant workers, as well as debt relief for businesses and individuals.

India has so far unveiled a $23 billion economic plan to offer direct cash transfers to millions of poor people hit by its lockdown. In neighbouring Pakistan, the government has announced a $6 billion plan to support the economy.

"The priority for all South Asian governments is to contain the virus spread and protect their people, especially the poorest who face considerable worse health and economic outcomes," said senior World Bank official Hartwig Schafer.