December 22, 2005, The Statesman

A World Health Organisation (WHO)-funded study on the availability of essential medicines at state government hospitals across seven districts of West Bengal including Kolkata has found that only one-third of the core list of essential medicines of WHO are available at public hospitals.

Funded by WHO and Health Action International (HAI) and authored by Dr Santanu Tripathi, medical superintendent of SSKM Hospital, Dr Avijit Hazra, department of pharmacology, SSKM and Mr Dalia Dey of Consumer Unity & Trust Society (CUTS) among others, the survey found that only seven of the 21 drugs identified by WHO as essentials were available at the public hospitals of the state. Thirty two medicines (of which 21 are from the core list of the WHO/HAI methodology), were surveyed in 26 public organisations including rural hospitals and 35 private retail outlets spread over Kolkata and six other districts of West Bengal. Out of the 32 medicines surveyed, only 13 were available at the public hospitals surveyed that included four city-based hospitals — SSKM, RG Kar Medical College and Hospital, NRS Medical College and Hospital and Sambhunath Pandit Hospital.

Of the 13 (of the 32) essential medicines available, only amoxicillin 250 mg tablets/capsules showed over 90 per cent availability. Only four of the seven anti-bacterials were available. Isosorbide dinitrate, a very cheap emergency medicine for acute anginal attacks, was not available. The treatment of epilepsy would not be possible at public hospitals as neither phenytoin nor carbamazepine (or for that matter, other antiepileptics) were available. Diazepam tablets too were missing. There were no inhalers for asthmatics and also no drugs to calm acutely agitated psychiatric patients.

“The WHO/HAI manual provides a core list of 30 medicines. However, nine core medicines were removed from the survey because of known limited availability in West Bengal. As WHO/HAI methodology provides for inclusion of supplementary medicines reflecting local morbidity patterns, we included 11 medicines, which meant that 32 medicines in all were surveyed,” Mr Dalia Dey, one of the members of the survey team, told The Statesman.

The survey also found that medicines were readily available from private retail counters, but this comes at a price higher than international reference prices. Standard treatments are mostly affordable, provided that the earning member of a family draws minimum daily wages at rates specified by the government, the survey ruled.
The survey report, which was forwarded to WHO and the state health minister, principal secretary of the state health department and other senior health officials also made certain recommendations. The survey called for urgent steps to assess the functioning of the public distribution system for medicines in the state.