The repeated instances of drug shortages, many of them due to bureaucratic red tape, are particularly frustrating because the country is almost self-sufficient in TB medicines.
Dec 9, 2024 05:46 IST First published on: Dec 9, 2024 at 05:01 IST
Last month, the World Health Organisation’s report on the global burden of tuberculosis listed significant positives in India’s fight against the disease. The country has registered an 18 per cent decline in TB incidence in the past 10 years and a nearly 25 per cent fall in deaths due to the disease in the same period. However, one key takeaway of the report was also that India is not on course to achieve its target of eliminating TB by 2025. The longstanding challenge to ensure that patients do not give up on therapy midway has, at best, been addressed partially. The Centre’s programme to procure and supply TB drugs to states has progressed in fits and starts. Supplies were erratic between 2020 and 2022 when a major section of the government machinery had to be mobilised to combat the Covid pandemic. Now an investigation by this newspaper has revealed that supply chain gaps have not been completely plugged. The government has denied shortages. But its response appears unconvincing – in the past, the Centre has cried off its responsibility at the last minute and told states to tap alternative sources because supplies got “delayed due to unforeseen or extraneous circumstances”. As it embarks on an ambitious project to reduce TB incidence and mortality in 347 worst affected districts by March 2025, the Union Health Ministry must make sure that government pharmacies in these areas have enough reserves. Forcing government TB centres to ration drugs would defeat the programme’s purpose.
The repeated instances of drug shortages, many of them due to bureaucratic red tape, are particularly frustrating because the country is almost self-sufficient in TB medicines. When stocks are adequate, government medical centres provide patients with medicines for three months. This obviates the need for frequent visits to a healthcare facility. However, chances of interruption in therapy increase when the critically ill or their family members – by all accounts, a large majority of them are from lower-income groups – need to visit a medical centre every few days or are forced to buy drugs from a private pharmacy. TB patients are severely immuno-compromised. Even a day’s break in therapy can lead to a relapse of symptoms and make a patient vulnerable to the drug-resistant strains of TB.
In September, the government approved the use of a new therapy which can improve treatment outcomes considerably for patients of multi-drug resistant TB. For the more than 75,000 people who get affected by this more virulent form of the disease every year, timely access to medicines could be a matter of life and death. It’s time the government makes uninterrupted supply of drugs a priority.
