Medicine ‘scam’ amid high anaemia in Punjab: Pop the iron pill before it expires | punjab$dont-miss | Hindustan Times
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Medicine ‘scam’ amid high anaemia in Punjab: Pop the iron pill before it expires

Health dept sets up special camps to distribute 2-crore tablets; minister says medicines worth Rs 6.28 crore were procured for ‘commission’ by officials during the previous govt’s regime

punjab Updated: May 20, 2017 22:56 IST
Sukhdeep Kaur
An anaemic patient — showing the symptom of swollen feet — at a hospital in Ludhiana.
An anaemic patient — showing the symptom of swollen feet — at a hospital in Ludhiana.(HT File Photo)

The hearty Punjabi meal does not mean it’s healthy too. The incidence of anaemia in Punjab has grown by 40% among women in the reproductive age of 15 to 49 years, from 38% in the National Family Health Survey (NFHS) held in 2005-06 to 53.5% in the survey conducted in 2015-16. Though more common among women, the percentage of anaemic men too has doubled between 2005 (13.6%) and 2015 (25.9%).

A box of iron and folic acid tablets shows the expiry date of July 2017 at the Bathinda drug warehouse. (HT Photo)

This survey report was the basis for the Punjab Health Systems Corporation (PHSC) to order 33 crore tablets in 2015. Ironically, the same survey is now being quoted by the department to hold special camps for the first time in the state for anaemia.

In a letter dated April 26, 2017, written to all civil surgeons, PHSC managing director Varun Roojam has asked them to hold special camps owing to “significant population of Punjab suffering from anaemia, including 53% women between 15 and 49 years”.

Who’s anaemic in Punjab?
  • Children (between 6 and 59 months): 56.6%
  • Non-pregnant women (15 to 49 years): 54%
  • Pregnant women (15-49 years): 42%
  • All women (15-49 years): 53.5%
  • Men (15-49 years): 25.9%

It adds: “Sufficient amount of iron and folic acid tablets are available in the Bathinda and Kharar drug warehouses. A detailed report of the camps and distribution of tablets should be sent before May 25, 2017.”

But behind the urgency of the government is a glaring lapse — the iron tablets are due to expire in June, July, September and December this year. By health department’s own admission, two crore tablets in its warehouses will expire this year. A letter dated May 2, 2017, from the chief pharmacist of the Bathinda warehouse has also cautioned civil surgeons of the state that iron and folic acid tablets are “piling up in the store and not being distributed properly”. There are three government drug warehouses in Punjab at Bathinda, Kharar and Amritsar.

A dose of facts
  • Iron tablets ordered in 2015: 33 crore
  • Money spent: ₹6.2 crore
  • Tablets near expiry: 2 crore

The Punjab Health Systems Corporation orders 214 drugs on the essential drug list (EDL) every year costing ₹80 crore. The technical and financial bids are decided by a committee of experts comprising doctors and the lowest bid is accepted at the administrative level. So the responsibility for ordering the medicine is shared up to the level of the principal secretary of the health department.

Roojam says the demand for iron and folic acid tablets was raised under the Union government’s National Health Mission (NHM). “I took over just one month back. After I realised that two-crore iron tablets were due to expire, I ordered that special camps be set up to distribute them,” he told HT.

MINISTER SMELLS A SCAM

Punjab health minister Brahm Mohindra ruled out a “scam” in procurement of medicines when HT contacted him for comments on Thursday. He had then only blamed the previous government. “The health department is in a shambles. I am trying to put it in order. Why did the former health minister not ensure how much medicines were bought and distributed,” he said. The department was under BJP ministers, Surjit Jyani and Madan Mohan Mittal before him.

“The medicines were supposed to be distributed immediately but are still lying in government stores. These will expire in October this year and as a result, cannot be distributed now.”

However, on Saturday, Mohindra dubbed it as a “medicine scam”. “Iron tablets worth ₹6.28 crore were procured apparently by officials to get commission in the previous government. But a huge quantity is still lying in the government stores. Unfortunately, these will expire in October this year as a result these cannot be distributed now. An inquiry has been marked to the health secretary,” he said at a health camp in Ludhiana.

Former health minister Surjit Jyani said iron tablets should not fall short of the requirement. “Why is excess tablets being cited as a scam? Anaemia is high in Punjab and the tablets come cheap. The iron pills are distributed to children in schools, to pregnant women and other women too. There was no need for the department to hold special camps. The ASHA workers and ANMs (auxiliary nurse midwife) distribute them door to door in villages. If they feel there is scam, they can order a Central Bureau of Investigation inquiry into it,” he said.

GLARING LOOPHOLES

PHSC director Dr Rajesh Sharma says the demand for 33 crore iron tablets was raised by the state programme officer of the National Iron Plus Initiative (NIPI) for anaemia control under the Rashtriya Kishor Swasthya Karyakram (RKSK). “The tablets were ordered in June 2015 and came in three lots with different expiry dates. The ones expiring in June-July and September have already been consumed. The ones expiring in November, December too will be consumed by then,” he said.

“Tablets expiring in June-July and September have already been consumed. The ones expiring in November, December too will be consumed by then.”

But pictures of boxes of iron pills being released by the Bathinda warehouse last week show the expiry date of July and the ones being distributed at Bhai Mohkam Singh UPHC Sakatri Bagh hospital in Amritsar of September. There are discrepancies also on how the demand of 33 crore was worked out. Assistant programme officer, RKSK, Punjab, Yugesh Kumar, said the 33-crore figure was based on one-year consumption of 4.5 lakh women registered for antenatal care — one tablet a day —and two tablets a day for “65% women in the age group of 15 to 49 years who are anaemic”. He, however, could not explain why “65%” figure was taken and how many women fell under this category.

WHY NOT DISTRIBUTED?

Even if the number of tablets ordered by the Punjab health systems corporation was in keeping with the high problem of anaemia in Punjab, it still raises the question of why these were not distributed within a year of delivery.

“There is a nexus between health officials and pharma industry.”

“There is a nexus between the health department officials and the pharma industry. The medicines are ordered in excess or shown in excess on paper. The iron tablets ordered are also of poor quality. Some dissolve as soon as you open them. Earlier, pharma companies based in Baddi, Himachal Pradesh, with small turnover were winning the tenders by bidding the lowest amount. Later, the turnover criteria were raised to ensure better quality. Every year, medicines worth crores are procured and they are destroyed after expiry. But no one is held accountable,” an official of the health department said on condition of anonymity.