Rakesh Kakol, an engineer with Bengaluru Metro Rail Corporation Ltd., has been running pillar to post for over a week desperately trying to source Liposomal Amphotericin B for his colleague who is suffering from mucormycosis. But so far, he has not been able to get his hands on the potentially life-saving drug. “Even Bowring Hospital, where my friend is admitted, doesn’t have stock of Liposomal Amphotericin B,” he said.
The shortage of the drug is not limited to Bengaluru alone. Rangareddy from Raichur whose brother Anjaneya, 37, a lineman by profession, is admitted to a government hospital in the district, said, “The drug supply is very sporadic, it comes to our district once every four or five days. The treatment has been prolonged and my brother’s condition is worsening because of lack of medication,” he said.
With the drug not available in other districts as well, families are coming to Bengaluru in the hope that the situation will be better in the State capital.
While COVID-19 cases may have come down drastically, the number of active mucormycosis cases is still high. At present there are 2,462 cases of black fungus in the State. Bengaluru Urban has the highest number of active cases at 851 as on Wednesday.
However, the availability of Liposomal Amphotericin B has consistently not kept pace with the number of active cases. As on Wednesday, the State has a stock of 5,100 vials, sources in the Health and Family Welfare Department said. “A patient needs at least five vials every day. Clearly the available stocks are woefully inadequate,” said a senior doctor at a government hospital in the city, who did not wish to be named.
H.S. Prasanna, president, Private Hospitals and Nursing Homes Association, said the number of active mucormycosis cases hasn’t fallen sharply yet as the duration of treatment for the infection is much longer. “There is a severe shortage of Liposomal Amphotericin B medicine in the State. On an anecdotal basis, we feel only 30% of the demand is being met, pushing several patients into desperation. The supply of the medicine has been a problem from day one and hasn’t been fixed at all,” he said.
Trade regulations
PHANA has tried to import the medicine from abroad, but since the Union government has regulated its trade, private players are not allowed to import stock. “We made several applications, but have been turned down. Either the government must import adequate quantities or allow private players who can to do so,” he said.
Inadequate alternatives
Most hospitals are making do with using either Amphotericin injections, that are said to be nephrotoxic or Posaconazole, a drug said to be less than 30% effective for treating the infection. “We are treating most patients with Posaconazole, but its not very effective. Even when successful, the recovery is very slow, which may lead to other complications,” said Dr. Prasanna.
