Karnataka drug procurement running one year late

Primary Health Centres (PHCs) that provide essential medicines to crores of people in the rural areas of Karnataka have run out of basic drugs like paracetamol and insulin for diabetic patients, as the government has delayed funds for procurement.

The Karnataka State Medical Supplies Corporation Limited (KSMSCL) is responsible for procuring medical supplies and drugs for all state government health facilities in a centralised manner. But the corporation is yet to procure drugs for the financial year 2021-2022.

KSMSCL officials met on Wednesday to accept tender quotes by suppliers for essential drugs including programmatic drugs for HIV/AIDS, vector-borne diseases and some paediatric drugs.

The shortage of drugs is more evident at the Community Health Centre (CHC) and PHC levels. Of the Rs 130 crore sanctioned under the National Free Drugs Scheme (NFDS) in 2021-22, only Rs 16 crore has been disbursed.

Sources in the Health Department said centralised procurement and disbursal by the KSMSCL was the norm. “Funds are directly released to districts only to meet supply shortages and maintenance of buffer stock. We can disburse only up to 20% of NFDS funds, which is Rs 26 crore. The rest is used by KSMSCL to procure drugs centrally,” a source said.

State Health Commissioner D Randeep told DH, “In the first tranche, we have not released much to CHCs and nothing for PHCs. So the highest priority is to release to them first. They have been managing till now with the Arogya Raksha Samithi (ARS) funds (service fee collected from patients). We will ensure that the money reaches there first to tide over this immediate crisis."

He noted that ARS funds, required for essential maintenance expenditure, cannot be entirely diverted to drugs. “The KSMSCL procurement is delayed due to the Covid pandemic. The 2019-20 fund disbursal, which started in January 2021, is still going on. The 2021 budget was approved recently and tenders are yet to be called for that,” he said.

The supply can commence at the earliest only by February 2022. “We need to have some buffer space for the institutions to procure drugs. That is why we will shortly take a decision to release some money in the interim,” he added.

The health facilities that did receive paltry funds under the NFDS include district hospitals that got Rs 13 lakh instead of the usual Rs 25 lakh, taluk hospitals that received Rs 8 lakh instead of Rs 10 lakh and CHCs that received Rs 1 lakh instead of Rs 3 lakh.

At Moodabidri CHC in Mangaluru taluk, an officer said, “Our NFDS funds are nil. Even our ARS funds are zero. This has been the situation in 2020 too. Whatever drugs the KSMSCL provides, we take them. We get only below-poverty-line patients. How can we levy user’s fee for an outpatient consultation or an X-ray just to get ARS funds?”

Ganjimatta PHC in the same taluk ran out of paracetamol six months ago and doesn’t have insulin. “We don’t have insulin, antibiotics, paracetamol, ointments and creams. When people get fever after Covid vaccination, we need to give them tablets, don’t we,” a PHC officer asked.

Public health activist Dr Sylvia Karpagam said government health centres were already lacking crucial facilities like human resources, labs, drugs, referral system among others. “That they don’t have basic and essential medicines means even simple health conditions cannot be treated. Pregnant patients, children with common ailments, senior citizens with non-communicable diseases will be denied healthcare. For even minor ailments, people will have to travel long distances or go to private facilities. This will increase both morbidity and mortality besides cost. Clearly, we haven’t learnt any lessons from the pandemic.”

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