TB meds crisis: Ministry’s denial sparks outrage among patients

Union Ministry of Health skipped the second round of the high-level meeting at the UN on September 22

The Ministry of Health and Family Welfare (MoHFW) has finally responded to the allegations and reports of TB medicine shortages, dismissing them as a myth, a month after mid-day first flagged the problem. However, stakeholders on the ground, including TB survivors, patients, practitioners, and researchers, have lamented the statement that the ministry has failed to acknowledge the problem on the ground and has instead termed media reports highlighting the plight as "ill-informed and misleading."

"There have been some media reports alleging a shortage of anti-TB drugs in India and questioning the effectiveness of such drugs under the National TB Elimination Programme (NTEP). Such reports are vague and ill-informed, without any specific information on the availability of anti-TB medicines in stock," the statement by the ministry reads.

In multiple earlier reports, mid-day gathered first-hand accounts from TB patients and highlighted their plight, with many patients expressing fears for their lives due to a lack of access to medications. Primarily, there has been a shortage of Linezolid, Clofazimine, and Cycloserine, which are used to treat drug-resistant TB.

Notably, India has a target for TB elimination by 2025. However, the Union Ministry of Health skipped the second round of the high-level meeting at the United Nations' headquarters held on September 22, aimed at addressing the challenges in TB control.

A coalition of five anti-TB organisations has criticised the recent statement by the health ministry. "The TB community in India, consisting of TB survivors, TB advocates, Country Coordinating Mechanism members representing the TB-affected community, clinicians treating TB patients, and TB champions, is very concerned about the notice from the MoHFW today, saying that the TB drug stock-out situation is a myth and media hype," the anti-TB organisations statement reads.

The coalition, which includes TB survivors and activists from Mumbai, had earlier written to the health ministry requesting urgent intervention to address the shortages. "It is disheartening to see the recent communication from the MoHFW, which seems to disregard the very real struggles and suffering endured by the people on the ground," the statement said.

In its statement, the health ministry noted that the supply of medications is managed by the Central TB Division. It stated that "in rare situations, states were requested to procure a few drugs locally for a limited period using the budget under the National Health Mission (NHM) to ensure that individual patient care is not affected."

mid-day had earlier reported that due to issues with the tender for the procurement of medicines, the TB division had indeed asked the states to procure the medicines locally. However, health officials at the state as well as BMC level had noted that the states were asked to procure the medications at the very last moment.

The current situation

The ministry has claimed that Maharashtra has already centrally procured Cycloserine tablets. It noted that all the drugs are now available with sufficient stocks, with a range of six months. It also stated that more than 15 months' worth of stocks of Moxifloxacin 400mg and Pyridoxine are available under NTEP. Additionally, Delamanid (50 mg) and Clofazimine (100 mg) were procured in August and supplied to all states and UTs. Meanwhile, purchase orders were issued for the supply of Linezolid (600mg) and Cap Cycloserine (250 mg) in August. "The drugs are being dispatched to the states," MoHFW said in its statement.

"There is no way of cross checking these figures. There have been stockouts reported from across the country. They did the purchase for some medicines in August (after months of stockouts) but distribution is a long process," said Mumbai based TB survivor, Ganesh Acharya.

Gov't claims:

Qty of Stock available in Maharashtra as on 24.09.2023

Cycloserine - 250 mg
6,34,940

Linezolid - 600 mg
86,443

Delamanid - 50 mg
1,53,784

Clofazimine-100mg
79,926

Moxifloxacin - 400 mg
4,56,137

Pyridoxine
7,06,413

Qty of Stock available at national level as on 24.09.2023

Cycloserine -250 mg
14,79,857

Linezolid - 600 mg
9,95,779

Delamanid - 50 mg
11,37,802

Levofloxacin - 250 mg
28,85,176

Levofloxacin - 500 mg
33,27,130

Clofazimine - 100 mg
12,86,360

Moxifloxacin - 400 mg
2,72,49,866

Pyridoxine
2,72,99,242

2025
Year, India wants to eliminate TB by