30 June 2021 Page: 1/14 Original: English TRADE IN MEDICAL GOODS IN THE CONTEXT OF TACKLING COVID-19: DEVELOPMENTS IN 2020 INFORMATION NOTE1 KEY POINTS: • Imports and exports of medical goods were valued at US$ 2,343 billion in 2020. This represents growth of 16 per cent compared to the previous year. In contrast, the total value of world merchandise trade contracted by 7.6 per cent in 2020. • Trade in test kits and diagnostic reagents increased sharply in March 2020 when COVID-19 became a global pandemic. In December 2020, the monthly year-on-year increase reached 90 per cent for exports and 126 per cent for imports. Singapore and Lithuania are among the top ten exporters of these products. • The share of medical goods in world trade grew from 5.3 per cent in 2019 to 6.6 per cent in 2020. • Global trade in goods critical for fighting the pandemic, such as face masks, ventilators, sterilizers and ultrasonic scanners, grew by 31 per cent in 2020. • China became the largest exporter of COVID-19-critical medical products in 2020. It exported products with a value of US$ 105 billion, about 2.8 times its exports in 2019. Malaysia, which was among the top 10 exporters in 2020, registered a 52 per cent year-onyear increase. • The world’s top 10 exporting economies supplied about three-quarters of world trade of COVID-19-critical products, while the top 10 importers accounted for 62 per cent of world imports. • Diagnostic reagents and test kits account for around 10 per cent of per capita import expenses on COVID-19-critical goods in the economies with the highest incidences of COVID19. 1 INTRODUCTION This report provides a full update on trade in medical goods in 2020, following on from the previous update for the first half of 2020.2 It presents the 2020 trade statistics for medical goods from around 100 economies, as well as comparisons with 2019. The report includes a special case study on diagnostic reagents and test kits, which are critical products for monitoring the prevalence of the virus and constitute a crucial barometer for governments to determine policies to fight the COVID19 pandemic. 1 This document has been prepared under the WTO Secretariat's own responsibility and is without prejudice to the positions of WTO members or to their rights and obligations under the WTO. 2 "Trade in medical goods in the context of tackling COVID-19: Developments in the first half of 2020", issued on 22 December 2020. The original report previous to the present update and that of December 2020 was "Trade in medical goods in the context of tackling COVID-19", issued on 3 April 2020. 2 DESPITE THE OVERALL TRADE DOWNTURN, MEDICAL GOODS TRADE EXPERIENCED PHENOMENAL GROWTH IN 2020 The 14 per cent year-on-year nominal decline in world trade in goods in the first half of 20203 was mitigated by a much lower contraction of 1.5 per cent during the second half. The overall decrease in world merchandise trade in 2020 was 7.6 per cent.4 Trade in medical goods5 continued to register phenomenal growth of 16.3 per cent in 2020 compared to the 4.7 per cent growth of the same sector in 2019 (Chart 1). Preliminary 2020 figures for 100 economies registered US$ 2,343 billion in trade (i.e., exports plus imports) of medical products (Table 1). These figures correspond to a 6.6 per cent share of world trade in 2020, compared to a share of 5.3 per cent in 2019. This increase of 1.3 percentage points in the share of world trade is for a relatively small group of products (92 Harmonized System (HS) subheadings). Chart 1: Yearly trade growth in medical goods, by product group, 2019 and 2020 Growth Rate (%) 50 45 40 35 30 25 20 16.3 15 10 4.7 5 8.4 4.6 0 All medical products Medical equipment 18.8 4.3 Medical supplies 2019 2020 Source: WTO Secretariat Table 1: Trade in medical products, 2018-20 9.8 5.7 Medicine Product category All medical products Medical equipment Ventilators Medical supplies Test kits & diagnostic reagents 6 Medicine Personal protective products Face masks Value (US$ million) 2018 2019 EXPORTS 957,679 999,123 134,517 140,894 7,373 8,037 164,968 172,511 27,274 28,159 520,175 546,253 138,019 139,465 75,505 77,159 2020 1,159,674 150,985 13,944 204,391 39,249 603,226 201,071 136,257 47.2 1.5 Personal protective products Annual change (%) 2019 2020 4.3 16.1 4.7 7.2 9.0 73.5 4.6 18.5 3.2 39.4 5.0 10.4 1.0 44.2 2.2 76.6 3 Data sources for all figures cited in this information note are the Trade Data Monitor, the WTO Integrated Database and the WTO Data Portal. See the annex for a full list of medical products and their HS subheadings. 4 WTO Secretariat calculations based on data from the WTO Data Portal. 5 The list of medical goods and categorization can be consulted in Annex 1 and can also be found in the earliest version of this information note, "Trade in medical goods in the context of tackling COVID-19", issued on 3 April 2020. 6 HS subheading 3822.00 only. 2 Product category Hand sanitizers Hand soaps Other protective covers COVID-19-critical products All medical products Medical equipment Ventilators Medical supplies Test kits & diagnostic reagents 6 Medicine Personal protective products Face masks Hand sanitizers Hand soaps Other protective covers COVID-19-critical products Source: WTO Secretariat Value (US$ million) 2018 2019 37,068 35,941 22,040 22,914 3,406 3,452 294,717 303,915 IMPORTS 966,146 1,015,99 2 135,849 141,954 7,872 8,325 162,613 169,279 28,504 28,540 533,285 567,733 134,400 137,027 76,065 78,156 34,674 34,060 20,627 21,650 3,033 3,162 288,850 299,858 2020 35,062 25,923 3,830 394,824 1,183,170 155,545 14,919 201,548 41,160 620,049 206,027 141,409 35,581 24,915 4,123 398,996 Annual change (%) 2019 2020 -3.0 -2.4 4.0 13.1 1.3 10.9 3.1 29.9 5.2 4.5 5.8 4.1 0.1 6.5 2.0 2.7 -1.8 5.0 4.2 3.8 16.5 9.6 79.2 19.1 44.2 9.2 50.4 80.9 4.5 15.1 30.4 33.1 All medical product groups showed significant increases in trade in 2020 (Chart 2). Medicines have remained the largest category by trade value, with more than 50 per cent of the total share of medical goods both in 2019 and in 2020. However, even if trade in medicines increased in absolute US dollar values, with growth rates close to 10 per cent in 2020 compared to 5.7 per cent in 2019, its relative share decreased slightly from 55.3 per cent in 2019 to 52.2 per cent in 2020 because of the even more substantial increase in other categories. The highest share increase was for personal protective products, which accounted for only 13.7 per cent in 2019 but increased to 17.4 per cent in 2020. This product group also registered the highest trade growth – 47.2 per cent in 2020 compared to 1.5 per cent in 2019. In terms of value, trade in personal protective products grew by US$ 130.6 billion in 2020. This can be attributed to a more than 80 per cent increase in trade of face masks. The total trade value of face masks in 2020 reached US$ 277.7 billion. Among different types of face masks, trade of textile masks increased almost fivefold. Diagnostic reagents and test kits, used to determine the incidence rate of COVID-19, accounted for around 20 per cent of trade in medical supplies. These products, classified under HS subheading 3822.00,7 represented 3.4 per cent of trade of all medical products. The value of imports for 2018 and 2019 increased only by 0.1 per cent. However, in 2020, imports grew by 44 per cent, from US$ 28.8 billion to US$ 41.2 billion. The trade in products considered critical in the response to the COVID-19 pandemic grew by 31 per cent in 2020, valued at US$ 794 billion (i.e., exports plus imports).8 This is a significant increase compared to the 4 per cent growth in 2019 for the same group of products. 7 See the annex for a full list of medical products and their HS subheadings. 8 COVID-19-critical medical products include: disinfectants/ sterilization products; face masks; gloves; hand soap and hand sanitizer; patient monitors and pulse oximeters; protective spectacles and visors; sterilizers; syringes; thermometers; ultrasonic scanning apparatus; ventilators, oxygen masks; X-ray equipment; and other devices such as computer tomography apparatus. 3 Chart 2: Trade in medical goods in 2019 and 2020, by product category (percentage share) Source: WTO Secretariat 3. CHINA, GERMANY AND THE UNITED STATES ARE THE WORLD'S TOP TRADERS OF COVID-19-CRITICAL PRODUCTS The world’s top three merchandise traders – China, the United States and Germany – are also the top three traders for COVID-19-critical products. While the share of these three economies in total world merchandise trade was around 31 per cent in 2020, their share for COVID-19-critical products is even higher, at 41 per cent (Table 2 and Chart 3). The top 10 economies accounted for around 72 per cent of world supplies – although the shares of the economies ranked fifth (Mexico – 3.3 per cent) to 10th (Ireland – 2.3. per cent) were relatively small. 4 Chinese exports of products considered critical to combat COVID-19 almost tripled from US$ 38 billion in 2019 to US$ 105 billion in 2020. The share of these products more than doubled, from 12.6 per cent in 2019 to around 26.7 per cent in 2020. The surge of exports pushed China to the position of top exporter in 2020. Another economy that saw a big jump in exports in 2020 was Malaysia, which registered a 52 per cent annual increase. In terms of exports, even if the United States remained a top exporter, the value of US exports shrank by 0.7 per cent, possibly as a result of increased domestic demand. Another leading exporter that registered negative growth was Ireland, at -5.8 per cent. Growth was more moderate for the other top ten exporters – mostly less than 10 per cent. Nonetheless, even if these suppliers saw an increase in the value of exports compared to 2019, their relative shares of world exports decreased due to the even faster growth of China. Table 2: Top 10 exporters and importers of goods critical to combatting COVID-19 Economy (descending order of 2020 value) Value (US$ million) 2019 2020 1. China 38,195 2. United States 46,775 3. Germany 34,082 4. Netherlands 21,736 5. Mexico 12,137 6. Japan 12,182 7. Malaysia 7,901 8. Belgium 11,260 9. France 10,940 10. Ireland 9,439 Total share of top 10 exporters 105,457 46,470 36,863 24,285 13,163 12,340 12,014 11,913 11,354 8,892 1. United States 54,744 2. Germany 23,681 3. China 21,595 4. France 12,402 5. Japan 14,199 6. United Kingdom 10,628 7. Netherlands 16,031 8. Canada 8,013 9. Italy 7,727 10. Belgium 9,438 Total share of top 10 importers Source: WTO Secretariat 78,327 32,479 24,644 19,643 19,185 19,153 18,200 11,993 11,724 11,003 Annual percentage change (%) 2020 Exports 176.1 -0.7 8.2 11.7 8.5 1.3 52.1 5.8 3.8 -5.8 Imports 43.1 37.2 14.1 58.4 35.1 80.2 13.5 49.7 51.7 16.6 Share of all COVID-19critical goods (%) 2019 2020 12.6 15.4 11.2 7.2 4.0 4.0 2.6 3.7 3.6 3.1 67.3 26.7 11.8 9.3 6.2 3.3 3.1 3.0 3.0 2.9 2.3 71.6 18.3 7.9 7.2 4.1 4.7 3.5 5.3 2.7 2.6 3.1 59.5 19.6 8.1 6.2 4.9 4.8 4.8 4.6 3.0 2.9 2.8 61.7 In 2020, the United States remained the top importer of COVID-19-critical medical goods, followed by Germany and China. The United States sourced US$ 78 billion worth of products abroad and accounted for almost one-fifth of world imports. The shares of the other top importers were all less than 10 per cent. Imports of these 10 economies account for 61.7 per cent of total world imports of these products, a share lower than the 71.6 per cent share for the top 10 exporters. These comparative statistics show that exports of COVID-19-critical products are concentrated in a relatively small number of economies with production capacity. Among the shares of the top 5 % Share of world exports % Share of world imports importers of these products, the United Kingdom showed the highest increase compared with the previous year (80.2 per cent) followed by France (58.4 per cent), and Italy (51.7 per cent). Despite these three economies reporting high incidence rates of COVID-19, their respective shares of world imports in 2020 were each less than 5 per cent. All top importers showed double-digit increases in their shares of imports of COVID-19-critical products. Chart 3: Comparison of shares of exports and imports of COVID-19-critical goods, 2019 and 2020 (percentage share of world) Exports 35 30 25 20 15 10 5 0 2019 2020 Imports 45 40 35 30 25 20 15 10 5 0 Source: WTO Secretariat 4 THE TOP THREE IMPORTERS ARE ALSO THE TOP SUPPLIERS OF COVID-19-CRITICAL PRODUCTS FOR EACH OTHER The bilateral trade patterns among the top three economies during the first half of 2020 persisted throughout the year. The United States and Germany, the top importers for COVID-19-critical products, sourced a large proportion of their imports from China, the world's top supplier (Table 3). China had a 40.2 per cent share in the US market and more than a quarter of the share (26.5 per cent) of Germany’s market. On this set of medical goods, the imports of the United States from China grew by 158 per cent, amounting to an additional US$ 19 billion worth of critical products purchased from China in 2020. Mexico's share in the US market decreased from 18.5 per cent in 2019 to 14.0 per cent in 2020, although the value of this share increased by 8.4 per cent. Germany's share in the US market, as 6 well as the actual value of its exports to the US in 2020, decreased compared to 2019. China and Mexico supplied more than half of the COVID-19-critical products exported to the United States in 2020, an increase of 13 percentage points in their cumulative share, which was about 41 per cent in 2019. The growth in Germany's imports from China was as much as 310.5 per cent, which in US dollar terms represents an additional US$ 6.5 billion compared to 2019. Germany's reliance on foreign supplies is shown by the double-digit growth of its imports from its other two top partners, the Netherlands and the United States. Furthermore, the spread of its imports was less diverse in 2020, with its top three partners making up 46 per cent of the share of total German imports in 2020, compared to a share of only 32 per cent in 2019. China's imports were dominated by three partners which made up almost half of its COVID-19 supplies: the United States, Japan and Germany. However, the situation did not significantly change from that of the end of 2019, when COVID-19 was first detected. Japan increased its supplies to China by 13.8 per cent, but its share in the Chinese market remained constant at 19.0 per cent. The United States remained China’s main supplier, despite the fact that the value of its exports barely grew, and the United States lost a few percentage points in terms of market share, from 22.0 per cent in 2019 to 19.3 per cent in 2020. Although China's imports from Germany grew by 6.4 per cent, Germany's share in the Chinese market for these products fell slightly, from 12.6 per cent to 11.8 per cent. Table 3: Bilateral import statistics on COVID-19-critical products for 2019 and 2020 Importer Partner 1. United States 1. China 2. Mexico 2. Germany 3. Germany 1. China 2. Netherlands 3. China 3. United States 1. United States 2. Japan 3. Germany Source: WTO Secretariat Value of imports from partner (US$ million) 2019 12,216 10,107 4,489 2,094 3,347 2,062 4,751 4,108 2,725 2020 31,499 10,953 4,292 8,597 3,821 2,663 4,763 4,676 2,900 Partner's share of total COVID-19- critical goods (%) 2019 22.3 18.5 8.2 8.8 14.1 8.7 22.0 19.0 12.6 2020 40.2 14.0 5.5 26.5 11.8 8.2 19.3 19.0 11.8 Annual percentage change (%) 2020 157.9 8.4 -4.4 310.5 14.2 29.1 0.2 13.8 6.4 5 CASE STUDY: TEST KITS DETERMINE COVID-19 INCIDENCE RATE, WHICH IN TURN AFFECT GOVERNMENT POLICIES RELATED TO THE PANDEMIC COVID-19 was first detected in December 2019. By April 2020, the World Health Organization (WHO) had reported over 1 million cases of COVID-19 worldwide.9 The total number of cases reached 153 million worldwide in May 2021. The data on incidence and prevalence have been essential for governments when calibrating policy responses to combat the pandemic. These data can only be collected from the administration of massive numbers of reliable viral tests. According to the US Centers for Disease Control and Prevention (CDC), a case of COVID-19 infection or death due to COVID-19 are defined by meeting confirmatory laboratory evidence for COVID-19.10 Thus, the laboratory test is essential for diagnosis and treatment, as well as for collecting reliable statistics to support policy responses. As the current vaccine production is insufficient for global needs, proactive and reliable testing remains one of the most effective means to identify high 9 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline#! 10 https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/about-us-cases-deaths.html 7 incidence areas and implement the necessary public health protocols to limit the spread of this highly contagious disease. Diagnostic reagents and test kits, including reagents based on polymerase chain reaction (PCR) for COVID-19 tests, are classified under HS subheading 3822.00.11 Since the beginning of the pandemic, many economies have relied on an international supply of diagnostic reagents and test kits to perform tests. Chart 4 represents the trends for the monthly trade of diagnostic reagents and test kits, and shows how different the trade pattern was for the pre-pandemic months, when the trend was mostly flat, from the trend after the pandemic began, towards the end of 2019. The volume of trade rapidly increased as more cases were reported. In December 2020, the monthly year-on-year increase (compared to the same month of the previous year) of exports of diagnostic reagents and test kits was 90 per cent, while imports had increased by 126 per cent. Chart 4: Monthly trend of exports and imports of diagnostic reagents and test kits, June 2019 to December 2020 Billion US$ 6.0 5.0 4.0 3.0 2.0 1.0 0.0 Virus identified, Dec 2019 WHO declared COVID-19 a PHEIC,1 Jan 2020 1 million cases, reported, April 2020 Exports Imports 1 Public health emergency of international concern Source: WTO Secretariat In 2020, the United States, Germany, the Netherlands and the United Kingdom were both the top four exporters and the top four importers of diagnostic reagents and test kits and were ranked in the same order (Table 4). The United States supplied more than a quarter of these products in 2019, but its share shrank to 22 per cent in 2020. The top ten exporters accounted for a little less than three-quarters of world supplies. The major suppliers from Asia were the Republic of Korea, China, Singapore and Hong Kong, China, which have a collective share of around 16 per cent. Three-digit growth rates were registered in the Republic of Korea, China, Lithuania and Hong Kong, China. The Republic of Korea, which had less than a 1 per cent share of world exports for diagnostic reagents and test kits in 2019, increased its share of exports almost sixfold and ranked as the fifth highest exporter, with a 5.3 per cent share of world exports of these products. On the other hand, exports from Singapore decreased by 7.9 per cent compared to 2019. 11 The HS description of subheading 3822.0 is “Diagnostic or laboratory reagents on a backing, prepared diagnostic or laboratory reagents whether or not on a backing, other than those of heading 30.02 or 30.06; certified reference materials”. 8 Notable among the top ten importers are high-income economies which have also reported a high incidence of COVID-19. The United Kingdom, Italy, Spain and Belgium registered the four highest increases in imports of test reagents and kits. China was a net importer in 2019 and its imports decreased by close to 7 per cent in 2020. It was the only economy among the top ten importers which slowed its imports but ramped up its manufacturing capacity, so that its export growth increased by 508.1 per cent and it became a net exporter. Only around 42 per cent of test kits imports were shared among the rest of the world. Table 4: Top 10 exporters and importers of COVID-19 diagnostic reagents and test kits Economy WORLD 1. United States 2. Germany 3. Netherlands 4. United Kingdom 5. Korea, Republic of 6. China 7. France 8. Singapore 9. Lithuania 10. Hong Kong, China Rest of the world WORLD 1. United States 2. Germany 3, Netherlands 4. United Kingdom 5. Italy 6. France 7. China 8. Spain 9. Canada 10. Belgium Rest of the world Source: WTO Secretariat Value million US$ 2019 28,159 7,491 4,270 2,504 1,985 253 314 1,251 1,493 388 309 7,900 28,540 3,996 2,866 1,755 1,317 1,200 1,344 1,929 765 740 584 12,044 2020 EXPORTS 39,249 9,203 5,406 4,048 2,777 2,171 1,910 1,426 1,376 1,051 999 8,882 IMPORTS 41,160 5,361 4,567 2,685 2,434 1,944 1,871 1,796 1,355 1,094 980 17,073 Annual change (%) 2020 Percentage share in world (%) 2019 2020 39.4 22.9 26.6 61.7 39.9 757.2 508.1 14.0 -7.9 170.7 223.7 12.4 100 26.2 15.0 8.8 7.0 0.9 1.1 4.4 5.2 1.4 1.1 29.0 100 22.4 13.1 9.8 6.7 5.3 4.6 3.5 3.3 2.6 2.4 26.2 44.2 34.2 59.4 53.0 84.8 61.9 39.2 -6.9 77.3 47.8 67.7 41.7 100 14.0 10.0 6.1 4.6 4.2 4.7 6.8 2.7 2.6 2.0 42.2 100 13.0 11.1 6.5 5.9 4.7 4.5 4.4 3.3 2.7 2.4 41.5 Diagnostic reagents and test kits account for around 10 per cent of per capita import expenses on COVID-19-critical goods in economies with the highest incidences of COVID-19. The WHO reported more than 153 million COVID-19 cases worldwide as of the start of May 2021, with the top 10 economies listed in Table 5 accounting for around 64 per cent of the total. Of these 10 economies, France, the United Kingdom, Italy, Spain and Germany have the highest per capita import expense on diagnostic reagents and test kits. Based on import values, Germany spent 9 almost US$ 55 per person on test kits alone and almost US$ 388 per person on COVID-19-critical medical goods more generally. Table 5: Per capita imports spending on diagnostic reagents and test kits and on all COVID-19-critical goods for the 10 economies with the highest current incidences of COVID-19 cases Per capita imports Numbers spending on Economy of COVID- Per capita imports (US$) diagnostic 19 cases reagents and test kits (Top 10 total cases) (% of Diagnostic COVID-19-critical (% of spending on world) reagents and goods all COVID-19-critical test kits products) 1. United States 21.0 16.2 236.6 6.8 2. India 13.2 0.6 2.8 21.0 3. Brazil 9.6 2.6 16.9 15.2 4. France 3.6 27.5 288.2 9.5 5. Turkey 3.2 3.7 38.0 9.6 6. Russian Federation 3.2 2.4 46.6 5.1 7. United Kingdom 2.9 35.9 282.1 12.7 8. Italy 2.6 32.1 193.9 16.6 9. Spain 2.3 29.0 201.3 14.4 10. Germany 2.2 54.5 387.6 14.1 Source: WTO Secretariat As the top exporter of diagnostic reagents and test kits, the United States does not need to rely heavily on imports, and its per capita imports of diagnostic reagents and test kits were only just over US$ 16, amounting to around 7 per cent of its overall spending on imports of COVID-19-critical products (Chart 5). For these 10 economies, the average import expense on diagnostic reagents and test kits as a share of the total import cost of COVID-19-critical goods was 12.5 per cent. Thus, for every US dollar spent on imported critical goods related to the pandemic, 12.5 cents were spent on test kits. Chart 5: Comparison of per capita spending on imports of COVID-19 diagnostic reagents and test kits among the top 10 economies with highest incidence of COVID-19 cases US $ 60 50 40 30 20 10 0 United States India Brazil France Turkey Russian United Italy Federation Kingdom Spain Germany 10 6 THE AVERAGE WORLD APPLIED MOST-FAVOURED-NATION TARIFF ON TEST KITS WAS RELATIVELY LOW The applied most-favoured-nation (MFN) tariff for HS subheading 382200, which includes "Diagnostic reagents based on polymerase chain reaction (PCR) nucleic acid test", was relatively low at 2.1 per cent, based on the latest available data. Of the top 10 economies currently showing the highest incidence of COVID-19 cases, India imposes the highest import duty at 10 per cent. The other two economies for which this product is dutiable are Brazil (8 per cent) and the Russian Federation (5 per cent). For the other economies listed in Table 5, test kits and diagnostic reagents are duty-free. In fact, globally, more than two-thirds of economies do not impose any tariffs on this product and 20 per cent of economies apply tariffs of 5 per cent or less (Chart 6). Chart 6: Latest applied MFN tariff on test kits, by duty range (percentage of reporting economies) Duty Free 0 <- 2.5 % 2.5% <-5% 5% <-10% > 10 % 2.1% 11.6% 14.7% 5.3% 66.3% 11 ANNEX: LIST OF MEDICAL PRODUCTS12 Medicines (pharmaceuticals) HS HS short product description 2017 300213 Immunological products, unmixed, ... not for retail sale 300214 Immunological products, mixed, ... not for retail sale 300215 Immunological products, ... for retail sale 300219 Immunological products, n.e.s.13 300220 Vaccines for human medicine 300310 Medicaments containing penicillins … not for retail sale 300320 Medicaments containing antibiotics, … not for retail sale 300331 Medicaments containing insulin, … not for retail sale 300339 Medicaments containing hormones … not for retail sale 300341 Medicaments containing ephedrine … not for retail sale 300342 Medicaments containing pseudoephedrine "INN" or its salts, … not for retail sale 300343 Medicaments containing norephedrine or its salts, … not for retail sale 300349 Medicaments containing alkaloids or derivatives thereof, … not for retail sale 300360 Medicaments containing any of the following antimalarial active principles: … not put up for retail sale 300390 Medicaments consisting of two or more constituents mixed together for therapeutic or prophylactic uses, not for retail sale 300410 Medicaments containing penicillins or derivatives thereof … for retail sale 300420 Medicaments containing antibiotics, ... for retail sale 300431 Medicaments containing insulin but not antibiotics, ... for retail sale 300432 Medicaments containing corticosteroid hormones, ... for retail sale 300439 Medicaments containing hormones or steroids ... for retail sale 300441 Medicaments containing ephedrine or its salts, ... for retail sale 300442 Medicaments containing pseudoephedrine "INN" or its salts, ... for retail sale 300443 Medicaments containing norephedrine or its salts, ... for retail sale 300449 Medicaments containing alkaloids or derivatives thereof... for retail sale 300450 Medicaments containing provitamins, vitamins,... for retail sale 300460 Medicaments containing any of the following antimalarial active principles ... for retail sale 300490 Medicaments consisting of mixed or unmixed products ... for retail sale Source: WTO Secretariat ITA-E Pharma X X X X X X X X X X X X X X X X X X X X X X X X X X X WCO X X 12 Columns "ITA-E", "Pharma", and "WCO" indicate if the HS codes are also part of the 2015 WTO Information Technology Agreement Expansion (“ITA-E”), the 1995 WTO Pharmaceutical Agreement (“Pharma”) and its four reviews, or whether they are included in the WCO's HS classification reference for COVID-19 medical supplies. 13 N.e.s. is “not elsewhere specified”. 12 Medical supplies HS HS short product description 2017 220710 Undenatured ethyl alcohol, of actual alcoholic strength of >= 80% 284700 Hydrogen peroxide, whether or not solidified with urea 300120 Extracts of glands or other organs or of their secretions, for organo-therapeutic uses 300190 Dried glands and other organs for organo-therapeutic uses; heparin and its salts, … 300212 Antisera and other blood fractions 300290 Human blood; animal blood ...; toxins, cultures of micro-organisms and similar products 300510 Adhesive dressings and other articles ... put up for retail sale for medical, surgical, dental or veterinary purposes 300590 Wadding, gauze, bandages and the like put up for retail sale for medical, surgical, dental or veterinary purposes 300610 Sterile surgical catgut, similar sterile suture materials, … 300620 Reagents for determining blood groups or blood factors 300630 Opacifying preparations for x-ray examinations; diagnostic reagents for administration to patients 300650 First-aid boxes and kits 300670 Gel preparations designed to be used in human or veterinary medicine … 340212 Cationic organic surface-active agents 340213 Non-ionic organic surface-active agents 350400 Peptones and their derivatives; other protein substances and their derivatives, n.e.s.; … 350790 Enzymes and prepared enzymes, n.e.s. 370110 Photographic plates and film in the flat, sensitised, unexposed, for X-ray 370210 Photographic film in rolls, unexposed, for X-ray 380894 Disinfectants, put up in forms or packings for retail sale 382100 Prepared culture media for the development or maintenance of micro-organisms 382200 Diagnostic or laboratory reagents on a backing, prepared diagnostic or laboratory reagents and certified reference materials 392620 Articles of apparel and clothing accessories produced by the stitching or sticking together of plastic sheeting 401490 Hygienic or pharmaceutical articles 401511 Surgical gloves of vulcanised rubber … 401519 Gloves, mittens and mitts, of vulcanised rubber 701710 Laboratory, hygienic or pharmaceutical glassware, of fused quartz or other fused silica 701720 Laboratory, hygienic or pharmaceutical glassware having a linear coefficient of expansion <= 5 x 10 -6 per kelvin within a temperature range of 0°C to 300°C 701790 Laboratory, hygienic or pharmaceutical glassware n.e.s 901831 Syringes, with or without needles, used in medical, surgical, dental or veterinary sciences 901832 Tubular metal needles and needles for sutures, used in medical, surgical, dental or veterinary sciences 901839 Needles, catheters, cannulae and the like, used in medical, surgical, dental or veterinary sciences Source: WTO Secretariat ITA-E Pharma X X X X X X X X X X X WCO X X X X X X X X X X X 13 Medical equipment HS HS short product description 2017 841920 Medical, surgical or laboratory sterilizers 901050 Apparatus and equipment ....; negatoscopes 901110 Stereoscopic optical microscopes 901180 Optical microscopes 901811 Electro-cardiographs 901812 Ultrasonic scanning apparatus 901813 Magnetic resonance imaging apparatus 901814 Scintigraphic apparatus 901819 Other electro-diagnostic apparatus 901820 Ultraviolet or infra-red ray apparatus used in medical, surgical, dental or veterinary sciences 901890 Instruments and appliances used in medical, surgical or veterinary sciences, n.e.s. 901920 Ozone therapy, oxygen therapy, aerosol therapy, artificial respiration or other therapeutic respiration apparatus 902150 Pacemakers for stimulating heart muscles 902212 Computer tomography apparatus 902214 Apparatus based on the use of X-rays, for medical, surgical or veterinary uses 902219 Apparatus based on the use of X-rays 902221 Apparatus based on the use of alpha, beta or gamma radiations, for medical, surgical, dental or veterinary uses 902229 Apparatus based on the use of alpha, beta or gamma radiations, n.e.s 902230 X-ray tubes 902290 X-ray generators, high tension generators, control panels and desks, screens, … 902511 Thermometers, liquid-filled, for direct reading, not combined with other instruments 902519 Thermometers and pyrometers, not combined with other instruments 902780 Instruments and apparatus for physical or chemical analysis, or for measuring or checking viscosity … 903020 Oscilloscopes and oscillographs 940290 Operating tables, examination tables, and other medical, dental, surgical or veterinary furniture Source: WTO Secretariat Personal protective products HS HS short product description 2017 340111 Hand soap 340130 Hand soap 340220 Other cleaning products 382499 Hand sanitizer 392690 Face masks 630790 Face masks 900490 Protective spectacles and visors 902000 Face masks Source: WTO Secretariat ITA-E X X X X X X X X X Pharma WCO X X X X X X X X X X X X X X X X X X X ITA-E Pharma WCO X X X 14