‘We are down to borrowing medicines’: Mohalla clinics, once AAP govt’s crown jewel, are running out of essential drugs

The injection is 1 of galore indispensable drugs meant to beryllium provided by the Delhi government’s cardinal procurement bureau (CPA) to antithetic hospitals, mohalla clinics and dispensaries.

Except, for months now, this has not happened.

The Indian Express visited 3 authorities hospitals and six mohalla clinics successful Southeast, East and West districts and recovered a shortage of indispensable drugs — meant to beryllium disposable for escaped to patients — crossed the board.

The reason: Non-payment of vendors and a alteration successful tender conditions, arsenic a effect of which two-thirds of the companies didn’t enactment successful the tender process this fiscal year. To enactment the situation successful context, lone Rs 5 crore has been spent to procure medicines from the indispensable cause database (EDL) this twelvemonth — a acold outcry from Rs 164 crore successful the fiscal twelvemonth 2023-24 and Rs 247 crore the erstwhile year.

While larger hospitals are navigating the situation by procuring the drugs from section vendors, albeit astatine a higher cost, mohalla clinics and smaller hospitals are faced with a acold much dire situation. Officials estimation that adjacent if measures to code the contented are taken now, it volition instrumentality six months for the concern to normalise.

On the ground, desperation

At a mohalla session successful a JJ clump successful Southeast Delhi, patients lined up to conscionable doctors and cod medicines. Many near not with the drugs they needed, but with achromatic chits scribbled with the names of the medicines.

Poonam Devi, a nonmigratory of Molarband and a regular wager, had travel to the session for terrible limb symptom and itching. She said the doc told her to bargain the medicine from outside. “Mohalla clinics are a boon for mediocre radical similar us. But if medicines are retired of banal here, we’ll conscionable not bargain them since they’re expensive,” she said.

(Left) Patients astatine IHBAS. (Express Photo by Amit Mehra). (Right) An bare mohalla session successful Geeta Colony (Express Photo by Tashi Tobgyal) 

The doc present attends to astir 150 patients a day. “Since we can’t constitute ‘out of stock’ connected their prescription, we are conscionable verbally informing them oregon giving them chits to get the peculiar medicine from outside,” she said.

“We’re down to borrowing medicines from each other. We archer colleagues astir our requirements connected WhatsApp groups and stock what we have,” she added.

This besides played retired astatine a mohalla session located successful a slum successful West Delhi, wherever a doc anxiously typed connected her phone. She was sending a connection to a WhatsApp radical that has Chief District Medical Officers (CDMOs) and doctors of different mohalla clinics astir the dearth of medicines for treating diabetes, humor pressure, and different superior conditions.

The superior has a full of 533 mohalla clinics — erstwhile considered a crown jewel successful the Aam Aadmi Party’s healthcare portfolio — and 30 Delhi government-run hospitals.

In Southeast Delhi’s Govindpuri, the session had been unopen for the day, with locals saying the doctors person not been coming regularly ever since medicines ran out.

At a mohalla session successful Geeta Colony successful East Delhi, 2 pharmacists sat inside. “Medicines are not available, truthful astir patients person stopped coming,” said one.

The medicines scope from those prescribed for symptom relief, scabies, tegument infection, inflammation, and humor unit to diabetes.

This is evident astatine a pharmacy crossed the roadworthy from IHBAS, wherever relatives of respective patients gathered and paid retired of their ain pocket.

At hospitals nether the Delhi government, too, the concern is grim.

At the Institute of Human Behaviour and Allied Sciences (IHBAS), the begetter of a 22-year-old undergoing attraction for schizophrenia has been struggling to get medicines for six months.

With nary medicines for Parkinson’s disease, seizures and anxiety, panic upset and epilepsy either, patients person to acquisition them from outside.

This is evident astatine a pharmacy crossed the roadworthy from IHBAS, wherever relatives of respective patients gathered and paid retired of their ain pocket. Jatin, a pharmacy store owner, said: “Andar astir sab dawai khatam hai (almost each medicine is implicit astatine the hospital).”

At Aruna Asaf Ali Hospital successful North Delhi, medicines to dainty haemorrhoids, seizures, thyroid, gout and kidney stones, fungal infections, symptom relief, allergic rhinitis, nervus pain, acidity, slump and bacterial infections are successful abbreviated supply.

What went wrong?

Like galore different unresolved issues successful the Capital, this excessively is mired successful the government-bureaucracy tussle.

In July, Delhi Health Minister Saurabh Bharadwaj held a gathering wherever helium suggested CDMOs were partially to blame. “… availability successful presumption of EDL being projected to the authorities is misleading because, successful reality, CDMOs are not distributing disposable medicines to mohalla clinics. Therefore, adjacent though immoderate medicines are shown arsenic disposable astatine the territory level successful its store… those medicines are not disposable astatine the mohalla session successful reality,” helium alleged.

He besides wrote to past Chief Secretary Naresh Kumar: “It is the work of Secretary (Health) and CPA officers, particularly the Directorate General of Health Services, to guarantee medicines are procured done CPA. In lawsuit medicines are not disposable done CPA, alternate mechanisms should beryllium utilized to guarantee medicines are disposable astatine each mohalla clinics.”

He alleged though CDMOs person been demanding medicines for months, CPA has not placed orders. “They selectively ordered lone 5-10% of the benignant of medicines. The bid which had to beryllium placed successful March for the archetypal 4th was placed successful July, that excessively for 50%… of medicines demanded by CDMOs,” helium claimed.

But wellness section officials pointed to different lapses.

The Indian Express had earlier reported however cause suppliers had not received outgo for medicines worthy Rs 90 crore from the CPA for implicit six months. “The dues person present reached Rs 110 crore,” said a medicine supplier. On August 14, a radical of suppliers wrote to Bharadwaj, stating they had not been paid dues since September 2023.

A elder authoritative said that not lone was outgo delayed, but lone astir 100 suppliers bid for the procurement tender floated successful April, arsenic compared to implicit 300 the erstwhile time. “Out of these, lone 10 bidders qualified, compared to astir 175-200 successful erstwhile tenders. Out of the indispensable cause list, of 1,100 medicines, tenders were passed for lone 54 drugs for procurement,” helium said.

Recently, a pre-bidding gathering was conducted with the vendors successful the hopes of resolving the crisis. However, officials accidental that adjacent if a tender is floated today, it volition instrumentality six months to procure the medicines.

Officials besides said that aft the tender process was changed by erstwhile Chief Secretary Naresh Kumar, lone companies with a turnover of implicit Rs 150 crore annually are present eligible to enactment successful the bidding. This magnitude was Rs 18 crore till past year.

Sources said manufacturers of generic medicine are diverse, ranging from startups to MSMEs and larger firms. Common medicines oregon fast-moving items are mostly manufactured by smaller firms, having a debased turnover. Bigger firms marque specialised medicines specified arsenic cardiovascular and anti-cancer drugs and antibiotics. “90% of our wellness installation depends connected communal medicines mostly manufactured by smaller firms. Hence, abruptly expanding the turnover from Rs 18 crore to Rs 150 crore is restrictive,” said an authoritative successful the Delhi government.

In September, a reappraisal gathering of wellness section officials, the curate and L-G was held wherever the contented was discussed. Subsequently, the EDL has been finalised and tenders floated. They are yet to beryllium awarded.