Costly bungling

There is a serious public health situation developing in the country because of the continuing shortage of drugs for treating tuberculosis.

All over the country drugs for treating two major forms the disease -- paediatric TB and  drug resistant TB (DR-TB) -- have run out of stock. This will have serious consequences. Paediatric TB  affects children, the most vulnerable segment of the population.  In the case of DR-TB, where the virus has developed resistance to first line drugs, treatment is very expensive. The cost of treatment comes to about Rs 4 lakh for a patient and most patients cannot afford it. They depend on the government for regular and continuous supply of the medicines. Because of non-availability from the government’s anti-tuberculosis programme some of them have had to go to private suppliers. This has created problems like variance of dosage which can lead to resistance.

Tuberculosis drugs are centrally procured by the government and supplied to the states under its anti-TB programme. But there has not been any procurement since 2010 and the stocks have depleted now. There is no explanation why the procurement was stopped three years ago. Fresh procurement process has started now but it will take months to build up the stocks. Many patients may die for want of drugs by then. It is even feared that the DR-TB strain may become more virulent and its  new strains may spread. The situation is attributed to bureaucratic delays and bungling. The tendering process for procurement was stuck for some reason.  But there is also a charge that the situation has been deliberately created at the behest of multinational companies which want to market their costly drugs. 

The lapse on the part of  the health ministry, which has led to the present situation, should be investigated and those responsible for it should be held accountable. India has the dubious distinction of having   a very high rate of incidence of TB. It is estimated  that one person dies of TB every two minutes in the country. The campaign against TB is one of the earliest public health programmes in the country but complete success is far away. Bunglings like this will make the situation much worse. Even international bodies like Medicines sans Frontiers have expressed concern over the shortage and its consequences. The government should take immediate steps to solve the crisis. The procurement system needs review too. A decentralised system would have helped to avert situations like this.  

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