For the previous three months, Ashok and Sanjay Kumar, sufferers of a blood clotting dysfunction referred to as Haemophilia A, have been struggling to avail a life-saving drugs. Often, the injection is out there on the Haemophilia daycare centre at Lok Nayak Hospital, however for the previous three months, sufferers have been advised it’s out of inventory.
In September, issues got here to a head when a battle erupted between sufferers and docs and employees of the hospital, after they have been once more refused the injection, meant to forestall or handle bleeding.
The injection is one among many important medication meant to be supplied by the Delhi authorities’s central procurement company (CPA) to completely different hospitals, mohalla clinics and dispensaries.
Besides, for months now, this has not occurred.
The Indian Specific visited three authorities hospitals and 6 mohalla clinics in Southeast, East and West districts and located a scarcity of important medication — meant to be accessible free of charge to sufferers — throughout the board.
The explanation: Non-payment of distributors and a change in tender circumstances, on account of which two-thirds of the businesses didn’t take part within the tender course of this monetary yr. To place the disaster in context, solely Rs 5 crore has been spent to acquire medicines from the important drug checklist (EDL) this yr — a far cry from Rs 164 crore within the monetary yr 2023-24 and Rs 247 crore the earlier yr.
Whereas bigger hospitals are navigating the disaster by procuring the medication from native distributors, albeit at a better value, mohalla clinics and smaller hospitals are confronted with a much more dire state of affairs. Officers estimate that even when measures to deal with the problem are taken now, it is going to take six months for the state of affairs to normalise.
On the bottom, desperation
At a mohalla clinic in a JJ cluster in Southeast Delhi, sufferers lined as much as meet docs and gather medicines. Many left not with the medication they wanted, however with white chits scribbled with the names of the medicines.
Poonam Devi, a resident of Molarband and a each day wager, had come to the clinic for extreme leg ache and itching. She stated the physician advised her to purchase the drugs from exterior. “Mohalla clinics are a boon for poor folks like us. But when medicines are out of inventory right here, we’ll simply not purchase them since they’re costly,” she stated.
The physician right here attends to round 150 sufferers a day. “Since we are able to’t write ‘out of inventory’ on their prescription, we’re simply verbally informing them or giving them chits to get the actual drugs from exterior,” she stated.
“We’re all the way down to borrowing medicines from one another. We inform colleagues about our necessities on WhatsApp teams and share what we’ve got,” she added.
This additionally performed out at a mohalla clinic positioned in a slum in West Delhi, the place a health care provider anxiously typed on her telephone. She was sending a message to a WhatsApp group that has Chief District Medical Officers (CDMOs) and docs of different mohalla clinics in regards to the dearth of medicines for treating diabetes, blood strain, and different severe circumstances.
The capital has a complete of 533 mohalla clinics — as soon as thought of a crown jewel within the Aam Aadmi Occasion’s healthcare portfolio — and 30 Delhi government-run hospitals.
In Southeast Delhi’s Govindpuri, the clinic had been shut for the day, with locals saying the docs haven’t been coming often ever since medicines ran out.
At a mohalla clinic in Geeta Colony in East Delhi, two pharmacists sat inside. “Medicines are usually not accessible, so most sufferers have stopped coming,” stated one.
The medicines vary from these prescribed for ache aid, scabies, pores and skin an infection, irritation, and blood strain to diabetes.
At hospitals below the Delhi authorities, too, the state of affairs is grim.
On the Institute of Human Behaviour and Allied Sciences (IHBAS), the daddy of a 22-year-old present process remedy for schizophrenia has been struggling to get medicines for six months.
With no medicines for Parkinson’s illness, seizures and anxiousness, panic dysfunction and epilepsy both, sufferers must buy them from exterior.
That is evident at a pharmacy throughout the street from IHBAS, the place family members of a number of sufferers gathered and paid out of their very own pocket. Jatin, a pharmacy retailer proprietor, stated: “Andar virtually sab dawai khatam hai (virtually each drugs is over on the hospital).”
At Aruna Asaf Ali Hospital in North Delhi, medicines to deal with haemorrhoids, seizures, thyroid, gout and kidney stones, fungal infections, ache aid, allergic rhinitis, nerve ache, acidity, melancholy and bacterial infections are in brief provide.
What went flawed?
Like many different unresolved points within the Capital, this too is mired within the government-bureaucracy tussle.
In July, Delhi Well being Minister Saurabh Bharadwaj held a gathering the place he prompt CDMOs have been partly accountable. “… availability by way of EDL being projected to the federal government is deceptive as a result of, in actuality, CDMOs are usually not distributing accessible medicines to mohalla clinics. Due to this fact, despite the fact that some medicines are proven as accessible on the district stage in its retailer… these medicines are usually not accessible on the mohalla clinic in actuality,” he alleged.
He additionally wrote to then Chief Secretary Naresh Kumar: “It’s the obligation of Secretary (Well being) and CPA officers, particularly the Directorate Normal of Well being Providers, to make sure medicines are procured by way of CPA. In case medicines are usually not accessible by way of CPA, alternate mechanisms ought to be used to make sure medicines can be found in any respect mohalla clinics.”
He alleged although CDMOs have been demanding medicines for months, CPA has not positioned orders. “They selectively ordered solely 5-10% of the kind of medicines. The order which needed to be positioned in March for the primary quarter was positioned in July, that too for 50%… of medicines demanded by CDMOs,” he claimed.
However well being division officers pointed to different lapses.
The Indian Specific had earlier reported how drug suppliers had not obtained cost for medicines value Rs 90 crore from the CPA for over six months. “The dues have now reached Rs 110 crore,” stated a drugs provider. On August 14, a gaggle of suppliers wrote to Bharadwaj, stating that they had not been paid dues since September 2023.
A senior official stated that not solely was cost delayed, however solely round 100 suppliers bid for the procurement tender floated in April, as in comparison with over 300 the earlier time. “Out of those, solely 10 bidders certified, in comparison with round 175-200 in earlier tenders. Out of the important drug checklist, of 1,100 medicines, tenders have been handed for less than 54 medication for procurement,” he stated.
Lately, a pre-bidding assembly was carried out with the distributors within the hopes of resolving the disaster. Nonetheless, officers say that even when a young is floated at this time, it is going to take six months to acquire the medicines.
Officers additionally stated that after the tender course of was modified by former Chief Secretary Naresh Kumar, solely firms with a turnover of over Rs 150 crore yearly at the moment are eligible to take part within the bidding. This quantity was Rs 18 crore until final yr.
Sources stated producers of generic drugs are various, starting from startups to MSMEs and bigger corporations. Widespread medicines or fast-moving gadgets are usually manufactured by smaller corporations, having a low turnover. Greater corporations make specialised medicines akin to cardiovascular and anti-cancer medication and antibiotics. “90% of our well being facility relies on widespread medicines usually manufactured by smaller corporations. Therefore, abruptly growing the turnover from Rs 18 crore to Rs 150 crore is restrictive,” stated an official within the Delhi authorities.
In September, a evaluation assembly of well being division officers, the minister and L-G was held the place the problem was mentioned. Subsequently, the EDL has been finalised and tenders floated. They’re but to be awarded.
