Patna resident Sanjay Kumar Sinha was supposed to arrive in Gurugram on Wednesday so that he could be on time for his cancer treatment at a hospital here that stocks the immunotherapy drug he needs every 15 days. Except, following the nation-wide 21 day lockdown announced on Tuesday to curb the spread of the novel coronavirus (Covid-19), he knew he wouldn’t be able to board his flight.
Sinha, who is in the final stage of a tongue cancer that has also spread to his lungs, contacted the distributor of the drug, nivolumab, in Gurugram, but it was of no use.
“The distributor told us that there was no way for them to courier the injection because transport wasn’t available during the lockdown. We tried another distributor in Patna, but their supply comes from Kolkata and the situation is the same there,” said his wife, Neetu Sinha.
“It’s very risky to not be able to get the injection, because right now he is being treated to suppress the symptoms,” she said, adding that, before he took the drug, he would face difficulty breathing, his lungs would fill with water and he was not even able to move. “After two sessions of immunotherapy, he has been feeling a little comfortable, but the doctor is saying if he misses it, the problems may start again.”
In the midst of a nation-wide lockdown, unresolved disruptions in supply of essential medicines across state borders have left patients like Sanjay in the lurch.
Panic buying and stock outs of certain medicines haven’t helped matters either.
For instance, JNU Professor Archana Prasad has been taking hydroxychloroquine everyday for the last three years to treat an auto-immune disease. Without the drug, it becomes painful and difficult for her to put in the hours of work she currently is capable of. Delhi-based government official Rachita (name changed to protect identity), has also religiously been on this medication for the last six years to treat a similar condition. Without it, her arms and legs begin to swell up and she gets tired.
The two have been doing the rounds of pharmacies for the last few days in in the hopes that maybe one of them will have enough, or any, supply of hydroxychloroquine to keep them going after they run out–Archana has enough for two and a half weeks, while Rachita only has about a week’s worth of tablets.
“People have to understand that these are not illnesses that can be postponed,” said Prasad.
Some measures have been taken by various states to ease confusions about whether drug makers are still allowed to manufacture at this time, but movement of these products across state borders is still a problem.
“Even if one state has given complete clearance, they are stopped as soon as they cross the border,” said the executive of a large Indian pharmaceutical company on condition of anonymity.
“If the situation continues, and the government doesn’t pay attention to this, there will be serious shortages,” said Kailash Gupta, president of All India Chemists and Distributors Federation (AICDF). Drugs like insulin, certain brands of diabetes drug empagliflozin and prostate medication silodosin are already short in supply, according to him.
“Nobody expected the lockdown would last for 21 days…When such drastic measures are taken, there is bound to be some disruptions somewhere,” said Mankind Pharma chairman Ramesh C Juneja. However, pharma associations have been working hard to resolve this problem in collaboration with states and central ministries and he expects the problem “should be solved” in the next three days.
“Our factories are all working, whether it is Sikkim, whether it is Paonta Sahib, whether it is Baddi or Haridwar. Maybe the number of employees is short, but still work is going on,” Juneja told The Indian Express. “The only problem is with transportation…I don’t think there will be any scarcity of essential drugs, but the chances are in case the transportation system is not healthy, then these problems might come.”
As of now, the inability of the government to effectively pass on the message that pharma operations and movement of drugs is an essential service has led to “utter chaos” on ground, said the executive cited above.
“There is absolutely no distribution happening. Manufacturers are not able to supply. Transporters and stockists are getting beaten up. You hear one story of one person going through this and the entire system stops,” the executive said.
“At the ground level, the administration is just not able to differentiate between those involved in essential services and those who are not.” The company is manufacturing at 50-60 percent of its capabilities, while it’s distribution network is working at “not even” 10 percent of its capacity.
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