Mumbai: Medicine shortage hits ‘home TB patients’ hard

If drug-resistant TB patients miss even a single dose, it leads to further resistance, says a doctor. Representation pic

A 28-year-old Malad East resident, who suffers from multidrug-resistant TB, has missed several doses of her medicine over the past two months. Since getting diagnosed last April, she had been getting her free-of-cost tablets from the WHO-backed DOTS centre. However, these have been facing a severe shortage.

The Malad East resident, after initial hospitalisation, continued receiving treatment at home, thanks to directly observed treatment, short-course (DOTS) backed by the World Health Organisation (WHO).

The programme is implemented across the country by municipal corporations where a health worker oversees the dosage of medications for patients. The purpose is to ensure that nobody misses a dose of these critical medicines. The medicines are available at the civic-run centres mostly.

Relatives of patients at the waiting area of Sewri TB hospital. The hospital has managed to it maintain its stock of medicines. Representation pic

However, there has been a shortage of Linezolid, Clofazimine and Cycloserine, which are used for patients suffering from extensively drug-resistant tuberculosis (XDR-TB) and multi drug-resistant tuberculosis (MDR-TB), at the BMC-run centres in Mumbai.

Not financially strong

Many like the Malad resident have missed their daily doses or had to shell out hundreds of medicines they bought from medical stores. A strip of six tablets of Linezolid cost Rs 210. Most of the patients availing the DOTS benefit do not have a strong financial background to rely on private pharmaceutical stores.

"These medicines are expensive, and I missed my dosage for a few days because I couldn't afford them. The consequence is severe pain," the Malad resident said. At different instances, either one or more than one of the three medicines was unavailable at DOTS centres.

"Linezolid has been unavailable for the past two months, Clofazimine supply has been inad-equate for the number of patients coming in, while we have been getting Cycloserine stock that is closer to the expiry date," said a health worker at a DOTS centre in M East ward.

Missing dosage is bad
Dr Lalit Anande, former head of Sewri's TB hospital, said, "These medicines are antibiotics used in drug-resistant TB patients. It is highly problematic if patients miss even a single dose, because then, it leads to further resistance to these medications."

A worried husband of another 26-year-old TB patient, from Andheri East, said, "My wife has not taken her Linezolid dosage since June." He then asked this reporter frantically, "Nothing will happen to her, right?"

The couple bought a packet of Linezolid from a medical store only on Thursday. "We do not know what kind of TB she has, but she has been asked to take this medicine every day with-out fail for 18 months," he added.

By Monday

Deputy Executive Health Officer and Mumbai TB Officer Dr Varsha Puri said, "The shortage has now been taken care of. The medicines will be available at all BMC-run centres by Monday. We have already distributed Cycloserine."

Meanwhile, the municipal union addressed a letter to Additional Commissioner (Health) Sudhakar Shinde and Health Department Head Daksha Shah, highlighting the shortage and requested the BMC to address it immediately.

"The employees are facing the anger of the patients due to the shortage," said Ramakant Bane, the general secretary of the union. A health worker admitted that patients' relatives are getting impatient and venting at the staff. "But, it is not their fault. They need the medi-cines," he added.

19,311
No of cases at public health facilities in Mumbai