India’s public health system has run out of life-saving tuberculosis medicines for children and critical testing kits for Aids patients, causing an outcry among patient groups who warn that the shortages could cost lives and worsen problems of drug resistance.
The shortages have affected the two infectious disease control programmes that are seen as rare bright spots in India’s otherwise dismal public healthcare system. Experts say health ministry officials apparently failed to ensure timely orders for the supplies, placing many lives at risk.
“It’s very disturbing,” said K. Sujatha Rao, the former top bureaucrat in India’s health ministry. “It’s a major system failure and it’s not acceptable when infectious diseases are involved.”
A health ministry spokesman said he was not authorised to comment on the shortages. Other senior ministry officials did not return phone calls. The government has previously denied running out of TB medicine – a so-called “stock-out” – though it admitted its “buffer stock” was running low.
Leena Menghaney, Médecins Sans Frontières project manager for the campaign for access to essential medicines, said frontline treatment centres in many parts of India were without the TB drugs and Aids testing kits they needed.
“It’s not just having enough reserve of drugs or buffer stocks,” she said. “The definition of a stock-out is when a patient comes to your centre and goes back without a drug or a diagnostic. And that is definitely happening.”
India has one of the world’s heaviest tuberculosis burdens, with an estimated 300,000 people dying from the disease each year, while an estimated 2.4m people live with HIV/Aids.
Delhi has pledged to provide free treatment to all TB patients, about 1.5 of whom take a six-month course of first-line drugs every ear. India has also committed to providing antiretroviral treatment to all Aids patients who need it and at present has about 400,000 people receiving the life-saving medicines.
However, MSF says both the TB and HIV programmes are facing critical shortages of essential supplies as a result of India’s poor procurement systems.
Public hospitals and groups providing TB treatment using government-provided drugs ran out of the medicine used to treat children months ago, forcing some doctors to resort to the risky practice of cutting adult pills in half.
Delhi has now placed an emergency order for the paediatric TB medications, which it hopes to have by the end of the month. MSF says shortages of medicines for drug-resistant TB, a worsening problem in India, have also been reported in some parts of the country.
This week, Aids patient groups complained that many government treatment centres had run out of CD4 testing kits, used to determine whether people living with HIV need to start antiretroviral treatment. MSF is also investigating reports that tests used to monitor Aids patients' viral load, a part of monitoring whether treatment is effective, are also starting to run out in Mumbai.
Ms Menghaney said the shortages of TB medication and the lack of diagnostic tests for Aids patients could result in many poor Indians, who often travel long distances to reach health centres, dropping out of treatment.
“When you tell a person who is HIV positive that the test kit is not available, some of them never return,” she said. “They are just lost.”
Source: Financial Times