Amphotericin B, an antifungal drug, is used to treat mucormycosis, or black fungus, a rare fungal infection caused by a group of mould called mucormycetes.(ANI file photo)
Amphotericin B, an antifungal drug, is used to treat mucormycosis, or black fungus, a rare fungal infection caused by a group of mould called mucormycetes.(ANI file photo)

‘Get black fungus medicine from wherever in world’: Delhi HC to Centre

An unprecedented surge in mucormycosis infections, which was typically rare, has caused a clamour for the anti-fungal drug. Doctors have said that where they would previously see 10-15 cases a year, they now have close to a 100 within weeks.
By Richa Banka, Hindustan Times, New Delhi
UPDATED ON MAY 21, 2021 06:34 AM IST

The Delhi high court on Thursday suggested that the Centre should procure Amphotericin B, a drug required to treat mucormycosis, internationally to meet the shortage in the country, saying that this is the only way to bridge the gap between demand and supply.

An unprecedented surge in mucormycosis infections, which was typically rare, has caused a clamour for the anti-fungal drug. Doctors have said that where they would previously see 10-15 cases a year, they now have close to a 100 within weeks.

“We are not questioning your allocation… you are doing good work… You need to import this to bridge the gap between your plan to enhance the capacity and completing manufacture before we lose more precious lives. So act fast on this… Float a global tender and ask internationally... Make a global enquiry,” a bench of justices Vipin Sanghi and Jasmeet Singh said.

Seeking a status report from the Centre, the bench said, “You can make emergency imports… And we want you to act today… You have to get the medicine from wherever in the world. You have to take steps right now. Wherever it is available in the world get it…Time is at a premium and so are human lives.

The court also directed the Union government to file a status report, detailing the present production, the producers, their capacity, their enhanced capacity and by when can the enhanced capacity be put in use.

Amphotericin B, an antifungal drug, is used to treat mucormycosis, or black fungus, a rare fungal infection caused by a group of mould called mucormycetes. It causes blindness, organ dysfunction, loss of body tissue and even death if not treated in time. There has been a large number of cases since steroid overuse during Covid-19 has left many, particularly those with uncontrolled diabetes, particularly susceptible to the disease.

The issue of shortage of Amphotericin B was first raised by petitioner-lawyer Rakesh Malhotra. The court directed both the Delhi and Union governments to respond to reports of the shortage of the drug.

Senior advocate Rahul Mehra, for the Delhi government, told the court that the Centre has allocated 2,150 vials of Amphotericin-B (50mg) to Delhi for the period up to 31 May 2021, which includes 1,850 vials through Bharat Serums and Vaccines Ltd. and 300 through Mylan Laboratories.

He said that 600 vials have also been allocated through Cipla Ltd. However, stock has not yet been received. Mehra argued that the supply is much less than the demand.

The Centre told the court that there are 197 patients in Delhi and each requires 42 vials for a week, not 90 vials, as claimed by Delhi government. It said that, by this calculation, Delhi would require 8,400 vials per week.

The central government’s standing counsel Kirtiman Singh told the court that there is a shortage due to rise in the cases of mucormycosis.

On the suggestion of the court to procure it from foreign countries, Singh said that the drug is generally used for a disease known as Kala Azar, or black fever in some countries. He said the Centre will request for the drug from the countries which are producing it and also list steps to increase its production.

He also said that one of the five companies, Bharat Biotech, has already agreed to double its production capacity.

He said on May 20 when the overall allocation across the country was 15,960, 430 vials were given to Delhi. He also said that there are 7,251 patients of black fungus in the country and 200 in Delhi, so the case load in the national capital is 3% of the country’s.

Mehra said that Delhi government is seeking 100,000 vials of the medicine, which the city is estimated to need in the next five weeks, and the state government was not misplaced in asking the Centre for these vials.

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