Shortage of TB medicines: ‘Please address this immediately, Mr PM’

At least 113 advocacy groups and 776 individuals worldwide have addressed a letter to the Ministry of Health and Family Welfare MoHFW and Prime Minister Narendra Modi urging immediate action to address the shortage of essential TB medicines in India Interestingly on October 1 the ministry issued a press release denying any shortage of TB drugs in India This is the second such statement after the first by it on September 26Among the signatories to the letter is the Mumbai District Tuberculosis Control Society as DOTS centres across the city have been experiencing shortages of drugresistant TB medicines such as Moxifloxacin Lfx Cycloserine Cs Linezolid Clofazamine Pyridoxine and Delamanid FGD1st line since JuneThe letter highlights the concern that drug stockouts at the state level may lead to further TB drug resistance in people who are forced to interrupt their treatment potentially rendering it ineffectiveThe letter was written on September 22 ahead of the second highlevel meeting for TB elimination held by the United Nations which India did not attend and it was signed and released by advocacy groups on September 29The signatories include groups from Kenya the United States Uganda the United Kingdom Canada Niger Zambia the Democratic Republic of the Congo and other countriesShortages despite assurancesmidday has carried multiple reports highlighting the shortage since midAugust due to issues in the tendering process by the Central TB Division CTD Even as the Union health ministry assured an adequate stock of crucial TB medications in Maharashtra on September 26 districtlevel officials said there is still a shortage of Cycloserine and there are concerns about the lack of clarity regarding when the situation will be resolved The medicine is used to treat DRresistant TB patients and is prescribed along with other drugs ldquoWe have received one monthrsquos stock for Linezolid and Clofazamine from CTD letrsquos see what the situation is once it ends No Cycloserine so far there is likely some problem at the manufacturerrsquos endrdquo said a DOTS centre official from MumbaiThe health ministryrsquos statement noted that Maharashtra has already procured Cycloserine tablets from the CTD with 634940 tablets available as of September 24However even district TB officials from other places like Palghar and Thane have talked about a shortage of Cycloserine One official from Nashik also said that there is still a shortage of other DRTB drugs In some of these cities including Mumbai officials also noted that they have a shortage of funds to procure adequate stock of DRTB drugs locally after receiving permission from the higherups to do soldquoThis shortage has persisted for the past three months We are still facing issues with drugresistant TB medicines The stock will likely be exhausted in eight to 10 days We have approximately 100 DRTB patients We have reached out to other municipal corporations for help The situation is expected to improve by next weekrdquo said an official from Nashik districtStock from GujaratStatelevel officials acknowledge that some medicines remain inadequate across Maharashtra ldquoWe are still trying to procure Cycloserine stock from Gujarat We hope it will arrive by next weekrdquo said a statelevel official who is part of the TB elimination programmeThere are approximately 5000 DRTB patients across the state who rely on the governmentrsquos supply of medicines and have either been spending exorbitant amounts on purchases from private medical shops or missing out on their doses When asked if there are any plans to reimburse such patients for the expenses incurred the official said there are no plans for the same at the moment but it can be taken into considerationMinistry statementA statement released by the union Ministry of Health and Family Welfare on Sunday slammed media reports claiming a shortage of antiTB drugs in India Such reports are false misleading motivated and seem deliberately intended to deceive and misguide people it said The press release further states ldquoProcurement storage maintenance of stock and intime distribution of antiTB drugs amp other materials are being done at the Central level under the National TB Elimination Programme NTEP In rare situations States are requested to procure few drugs locally for a limited period by utilizing the budget under National Health Mission NHM so that individual patient care is not affectedrdquo Health officials had claimed they were informed about this at the last minute hence the shortage It adds that purchase orders were issued for the supply of 3 FDCP Linezolid600mg amp Cap Cycloserine250 mg in August 2023 ldquoPreDispatch Inspection PDI for 3 FDCP Linezolid600mg amp Cap Cycloserine250 mg and Quality Test reports for 3 FDCP and Cycloserine have come These drugs are being dispatched to the states Release Orders are being issued from 25092023 onwardsrdquoIn addition the release says as of September 30 in the country there are 273598 Cycloserine tabletscapsules available 27217061 of Moxifloxacin 769883 of Linezolid 27224272 of Pyridoxine 4526200 of Clofazamine and 1031770 of Delamanid