Among the tragedies that befell us last year, was the painful stockout of some of the most essential stocks in our hospitals. There was a time when had run out leading to some agonizing moments for hospitals running ICUs. This included the extreme trauma when patients died gasping for Oxygen. Then we ran out of drugs that were being tried out in extreme cases- Remdevisir being the most in demand. Earlier we had a situation when we did not even have enough testing kits, and in some places not even enough PPE and masks for frontline health care workers and policemen, leading to thousands of avoidable deaths.
The lesson learnt is therefore that no amount of preparedness is ever enough. In Intensive care units, inventory management cannot follow the Just in Time and the frugal principle that the automobile sector has pioneered to great success fifty years ago. Where we deal with life and death, the supply should far exceed demand, a simple principle that and drug administrators must internalize if we are to work towards eliminating highly avoidable death and morbidity.
One of the key elements in this preparedness to fight epidemics is the strategic stockpiling of drugs, vaccines and medical diagnostic equipment. We have as of now 3 crores cases of infection in India, nearly 17% of the worldwide figure. We have also nearly 4 lakh deaths, which is ten percent of the total globally. It is high time we get ready with a better healthcare response, especially if we are looking at a highly probable third wave this winter. Tackling human resource shortages by way of doctors and nurses is going to take a while, even if undertaken at a war footing.
But ensuring a steady supply of drugs and equipment is what we must work towards with urgency. Keeping enough stocks of drugs and vaccines, without endangering the supply of the same to other countries, is a matter of simple logistics and international cooperation and can be achieved quickly. The manner in which some countries like the US hoarded supplies of Remdevisir is what the global health community must guard against. India, with its large capacity to produce drugs and vaccines must develop a clear strategy on stockpiling.
The industry has been ensuring supply of medicines needed except for a few Covid-19 drugs which saw sudden increase in demand due to an unexpected surge in cases. For instance, which was addressed by companies by ramping up production. However, a crucial point to note in this situation is the collaborative effort by the government and industry to ensure steady surveillance and supply of essential medicines. We continue to depend on China for imports of API's to manufacture bulk drugs and are now buying vaccines against Covid from all parts of the globe to meet the enormous supply demand gap that exists in the country. A carefully calibrated stockpiling strategy would have helped us enormously in handling this deadly second wave that came upon us.
Emergency stockpiles are important for a country like India where a pandemic can cause huge losses in no time. Stockouts lead to tremendous profiteering, substandard and counterfeit medicine and a significant increase in the Out of Pocket expenditure for any patient, leading to acute chronic poverty in millions of cases. We now have a fair idea of what drugs could be repurposed for handling Covid 19. Dexamethasone, a generic drug used for arthritis and asthma, proved to be a popular choice among doctors in ICUS. So did Remdevisir. However, stockouts and panic buying resulted in complete market chaos.
It is in this context that the Government of India and the MOFHW and the Ministry of Chemical and Fertilizers should quickly come up with a strategy that will make essential and repurposed drugs available at all times through robust surveillance at district, state and national level . This ought to be done without raising prices and without curtailing foreign trade in medicines and drugs. This has to be an internationally negotiated consensus on how careful stockpiling by governments would enable faster health care delivery and not deprive any country of drugs and equipments.
This article was originally published on ET HealthWorld
