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Mint
6 days ago
- Health
- Mint
With State hospitals' essential medicine stock less than 40%, Centre sounds alarm bell
New Delhi: India's public health system, a cornerstone for millions, faces a critical shortage of essential medicines and diagnostic services, even as the country grapples with a rising burden of communicable and non-communicable diseases. Several states and Union territories (UTs)–including populous ones such as Uttar Pradesh, Maharashtra, Delhi, Gujarat, West Bengal and Bihar, among many others–have less than 40% levels of essential medicines and diagnostic services available in government-run hospitals and health centres, said an official aware of the matter and as shown by a document reviewed by Mint. At the same time, the Centre has conveyed its unhappiness to states and UTs about consumers being unaware of a key central government scheme to provide free drugs at public healthcare centres. Gaps in implementation A communication from the Union health ministry on 7 May to the states and UTs, seen by Mint, pointed to gaps in the implementation of its FDSI (free drugs and diagnostics service initiative) program under the national health mission (NHM). 'These include gaps in the notification by state of the average number of drugs and diagnostics available across facilities, as compared to the recommended numbers outlined in the National Essential Drugs and Diagnostics Lists as per IPHS (Indian Public Health Standards)," the communication noted, adding that there is also a noticeable gap between data reported in state reports and data updated in the government's monitoring dashboard. However, the official cited above, who spoke on the condition of anonymity, said the matter of data gap is not worrisome. 'The states/UT governments have to update the data on the government's portal for effective monitoring and evaluation of FDSI," this person said. 'This is not a big issue; (it is) a regular matter." Also read | India's first public health university on the cards At present, a diagnostic module is being piloted in the DVDMS (drugs and vaccines distribution management system) to monitor the availability of diagnostic reagents and consumables. The DVDMS is an IT application that facilitates the implementation of the FDSI and improves the supply chain of drugs, sutures, and surgical items for district drug warehouses across India. The health ministry has now told states and UTs to update their lists of essential drugs and diagnostic tools to match national guidelines. They also need to evaluate their specific needs and provide feedback on any drug or diagnostic service. Queries emailed to the office of Union health minister J.P. Nadda, health secretary Punya Salila Srivastava, and health ministry spokesperson remained unanswered till press time. Prof Dr K Srinath Reddy, former, President of Public Health Foundation of India (PHFI): 'Availability of essential drugs and diagnostics at all public healthcare facilities is pivotal for meeting both major indicators of universal health coverage, which are financial protection and service coverage. Drugs and diagnostics contribute to a very high level of out of pocket expenditure, resulting in financial hardship to those who need healthcare, especially for chronic conditions. Health outcomes will be poor if healthcare providers are handicapped by absence of essential drugs and diagnostic aids. All efforts must be made by state and central governments to urgently fill these gaps." What are the minimum thresholds? The Centre has been trying to implement the Indian Public Health Standards (IPHS) 2022 guidelines to provide uniform, high quality health services across all states. IPHS are essential benchmarks that ensure the delivery of minimum essential services through public healthcare facilities, including district hospitals, sub-district hospitals, community health centers, primary health centers, and sub health centres. In 2015, the Union health ministry launched the FDSI to provide free essential medicine at all public health facilities, with an aim to reduce out-of-pocket expenditure (OOPE). Both the marquee initiatives are being implemented under the National Health Mission (NHM) to achieve Universal Health Coverage (UHC), providing equitable, affordable and quality healthcare. Also read | Need thorough virtual checkups of public health facilities, Centre tells states According to the guidelines, a district hospital should have at least 375 essential medicines such as anti-infectives, cardiovascular medicines, anti-diabetic medicines, antidepressants, pain relievers, antineoplastic drugs, vitamin and mineral supplements, anticonvulsants, etc. A sub-district hospital needs to stock 325 medicines, community health centres 299 medicines, primary health centres at least 171 medicines, and sub-health centres need to store 105 medicines. As for free diagnostic services, a district hospital should have at least 134 diagnostic services, sub-district hospital (111), community health centre (97), primary health centre (63) and a sub-health centre must provide 14 services. Where are the gaps? According to information reviewed by Mint, states and UTs that have been red flagged by the Centre for having less than 40% availability of medicines as on 25 April 2025 are: Chhattisgarh, Kerala, Maharashtra, Mizoram, Nagaland, Punjab, Arunachal Pradesh, Assam, Bihar, Dadra and Nagar Haveli and Daman and Diu (DNHⅅ), Delhi, Gujarat, Haryana, J&K, Jharkhand, Manipur, Meghalaya, Rajasthan, Sikkim, Uttar Pradesh, Uttarakhand and West Bengal. Also read | Cell planned to find treatments and vaccines for future pandemics Further, the following have less than 40% availability of diagnostic services at the government health facilities: Andaman & Nicobar Island, Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Delhi, DNHⅅ, Kerala, Maharashtra, Mizoram, Nagaland, Punjab, Assam, Bihar, DNHⅅ, Delhi, Goa, Gujarat, Haryana, Himachal Pradesh, Jammu & Kashmir, Jharkhand and Karnataka, Ladakh, Lakshadweep, Madhya Pradesh, Maharashtra, Manipur, Meghalaya, Nagaland, Odisha, Puducherry, Punjab, Rajasthan, Sikkim, Uttar Pradesh, Uttarakhand and West Bengal Getting the message across The Centre has also raised concerns about common citizens and local public representatives often remaining unaware of FDSI, which limits their ability to fully utilize these essential services. The health ministry has directed the states and UTs to develop comprehensive strategies to promote awareness campaigns, and mandatory display of available drugs and diagnostic services at all health facilities. Dr Rajeev Jayadevan, public health expert & former past president, Indian Medical Association (IMA), Cochin Chapter, remarked that despite its goal to provide essential medicines and tests free of cost at public health facilities, many citizens — even in urban areas — apparently remain unaware of these entitlements. Also read | NMC asks medical institutions to establish dedicated Tobacco Cessation Centres 'This has resulted in a gap between planning and implementation," Jayadevan said. 'Limited public awareness and logistical hurdles are major barriers. While media coverage, posters and displays can improve visibility, real impact requires trained personnel, accurate data reporting, and digital integration via systems like DVDMS. Health equity starts with access — and access begins with awareness, supported by reliable systems that deliver."
Yahoo
19-05-2025
- Health
- Yahoo
Senate lawmakers move to step up vaccine tracking as vaccination rates fall
The Centers for Disease Control and Prevention last week reported 1,024 confirmed measles cases across 31 states — including three in New Jersey — so far in 2025, up sharply from 2024. (Photo by Illustration) Lawmakers on a Senate panel approved measures meant to bolster vaccine uptake and better prepare for future outbreaks in divided votes Monday, showing some vaccine doubts spurred by the pandemic have persisted in New Jersey. Both measures received votes of 5-3 from the Senate's health committee Monday, with all Democrats voting yes and all Republicans opposed. The first bill would require automatic enrollment in the state's vaccine registry, with some ability to opt out. The other is a resolution urging the state's residents to get immunized as vaccination rates fall and residents again contract some diseases once thought to be eradicated within the United States. The Centers for Disease Control and Prevention last week reported 1,024 confirmed measles cases across 31 states — including three in New Jersey — so far in 2025, up sharply from the 285 confirmed cases reported for all of 2024. Three, including two unvaccinated children, have died after contracting measles this year. 'As a pediatrician, words cannot express the angst that is felt in our profession when we know these deaths were preventable,' said Dr. Jennifer Chuang, vice president-elect of the New Jersey chapter of the American Academy of Pediatrics. The vaccine registry bill would require individuals not already enrolled in the New Jersey Immunization Information System, the state's vaccine registry, to be entered there when they next receive a vaccine. It would allow patients — or their parents or guardians — to file written requests not to be entered into the registry, though another portion of the bill would allow the commissioner of health to deny such requests during public health emergencies or outbreaks of communicable diseases, among some others. 'By making the NJIIS registry an opt-out system rather than an opt-in, the state will be able to gather more data to be better prepared for the next pandemic,' said Sen. Joe Vitale (D-Middlesex), the legislation's prime sponsor and the panel's chair. Under existing law, children born beginning in 1998 are automatically enrolled in the registry unless their parent or guardian opts out. Critics of the bill said automatic enrollment could turn some away from vaccination. 'I think that this could end up having a, once again, unintended consequence of people who may have ordinarily gone in and gotten a certain vaccine deciding not to because now they're automatically put into a registry because of any sort of potential threat of any sort of outbreak, even if it's inapplicable to why the person's going in,' said Sen. Holly Schepisi (R-Bergen). The resolution, a type of legislation with limited force of law, urges the Department of Health to increase awareness of measles within New Jersey, like by sending mailers on the benefits of vaccines and how to obtain them. The department is not required to comply with the resolution's urgings. Dr. Susan Boruchoff, director of clinical services and education at the Robert Wood Johnson Medical School's immunology and infectious diseases division, noted that the nation had 'just about completely eradicated measles from this country.' 'We had declared it eradicated — completely gone,' Boruchoff said. 'To have cases is different.' The rise in measles cases has coincided with declines in uptake of the measles, mumps, and rubella vaccine, more commonly called the MMR vaccine. Statewide, 90.4% of New Jersey teens aged 13 to 17 had received two doses of the MMR vaccine, the Department of Health said in an August 2024 brief. Uptake rates for the MMR vaccine, which is typically administered to children no older than six, are lower in some counties, according to Chuang. In Ocean County, 84.8% of students met school vaccination requirements in the 2023-2024 school year. Researchers have said a 95% vaccination rate is needed to maintain herd immunity against measles. Anti-vaccine activists who testified to oppose the resolution charged vaccines were broadly ineffective, citing prevention rates for flu vaccines, which target specific prominent strains of influenza and vary in efficacy year-to-year. There's little doubt the full Senate could find the votes to approve the measure, though protests over past vaccine measures could make that search more difficult. In late 2019, months before New Jersey reported its first case of COVID-19, thousands of anti-vaccine protestors descended on the Statehouse for days of concerted protests targeting a bill that would have ended the state's religious exemption to school, child care, and university vaccine requirements. Those protests — which included an appearance from anti-vaccine campaigner Robert Kennedy Jr., who is now U.S. secretary of health and human services, and enough calls to jam clog members' phone systems — stalled the legislation after peeling away support from a handful of Democrats in the Senate. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
