In the middle of North India’s air pollution season, with outpatient numbers having risen an estimated 20% above the baseline across hospitals in the national capital, the largest hospital run by the Delhi government is running short of drugs to treat respiratory illnesses, say patients.
At Lok Nayak Hospital, where complaints of breathing problems triggered by air pollution spike every winter, essential drugs including nebuliser solutions, cough syrups, multivitamins, and several inhalers are not available, forcing patients to buy them from private pharmacies.
Hospitals run by the Delhi government provide medicines to patients for free. Many of those who visit government hospitals are poor, and find it difficult to buy their prescribed medication. The cost of a metered-dose inhaler (MDI) typically ranges from several hundred to more than a thousand rupees per unit.
A woman from Daryaganj who gave her name as Nisha said she had been told that Bromhexine syrup and a multivitamin syrup prescribed for her 7-year-old son Naman were out of stock at the hospital pharmacy. Bromhexine is commonly prescribed to thin mucus, ease coughs, and relieve chest congestion in patients suffering from bronchitis.
Nisha, who said she had been visiting Lok Nayak for years, claimed that shelves had been getting increasingly empty over the past couple of years. “Kuchh nahin milta yahaan… Hamesha baahar se leni padti hai dawai (You get nothing here, you have to buy medicines from outside),” she said.
Naman had been ill for the past two weeks, and had suffered nosebleeds on a few occasions, Nisha said. “I have no income, and my husband teaches in a nearby school. I am worried about Naman,” she said.
Forty-six-year-old Prem Kumar, who works as a security guard in Mayur Vihar, said he was unable to get MDI Tiova, NAC 600 tablets, and Bromhexine, which had been prescribed for his persistent cough and breathlessness.
A Tiova inhaler, which makes breathing easier by relaxing airway muscles and widening the airways, costs Rs 535. NAC 600, which is used to loosen mucus in the lungs, windpipe, and nasal passage, costs about Rs 330 for 10 tablets. Other commonly prescribed drugs are more expensive – the Seroflo 250 inhaler costs about Rs 914, and the Seroflo 250 Synchrobreathe about Rs 1,040.
Prem said he had stood in line for more than an hour, only to be told that the medicines were not available. “Ab baahar se loonga, kharcha toh aayega hi (I will now have to pay to buy the medicines from outside),” he said.
The average air quality index (AQI) in Delhi deteriorated to 373 on Thursday after having improved marginally to 334 on Wednesday from 354 on Tuesday, according to Central Pollution Control Board (CPCB) data. Air quality had slipped to the ‘severe’ category – above 400 – on Monday, Sunday and Saturday.
Since November 1, the daily average AQI in Delhi has improved to below 300 on only three days in November and two days in December. It has crossed 400 into the ‘severe’ category on three days each in November and December.
A 20-year-old student from Narela who gave his name as Laxman, said he could not get Budecort and Ipratropium that were prescribed for his mother. “I don’t have an income yet, and it is very difficult when medicines are not available,” he said.
Ipratropium is a bronchodilator that is prescribed for respiratory conditions such as chronic obstructive pulmonary disease (COPD) and, in some cases, asthma. It is available as an aerosol or nebulizer solution and as a nasal spray. Budecort is a brand-name medication containing the corticosteroid budesonide, which is primarily used as a long-term control or maintenance treatment for asthma and COPD.
Lok Nayak Hospital declined to issue a statement on the complaints of the shortage of drugs at the pharmacy. The Delhi Health Minister’s office did not respond to requests for a comment.
Sources at the hospital alleged that nebulisers and cough syrups of all kinds, and several inhaler medicines have been unavailable for several months now. “Only Asthalin (brand name for salbutamol/ albuterol), used to treat breathing problems like asthma and COPD, is available for now,” a source said.
A Delhi health official said medicines for the hospital were last procured in October. “That was about 25% of what is actually required,” the official said.
According to this official, the supply crunch is in part due to the government’s decision to stop all local purchase of drugs and route all purchases through the Central Procurement Agency (CPA), which involves a process of tendering.
Outside the pharmacy at LNJP Hospital in Delhi. (Photo: Ankita Upadhyay) 
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