Lockdown hits production of anti-TB drugs, health min seeks to ban export

India’s fight against Covid-19 might be costing it in its battle against tuberculosis (TB) with supply and production of a key anti-TB drug taking a hit amid emergency measures being taken to tackle the spread of coronavirus.

The industry, however, claims that the shortage is because of production hurdles at two pharma hubs Daman and Baddi (Himachal Pradesh) caused by restriction on inter-state movement of workers.
 

The health ministry has taken note of concerns raised by suppliers that because of limited material for production and manpower, the drug supplies could be delayed. The suppliers have said the delays are because of the force majeure in light of Covid-19 response.
 

The health ministry has asked the ministries of commerce, chemical and fertilizer and the department of pharmaceuticals to give directions to prohibit the export of anti-TB medicines, and ensure smooth supply of these drugs. It has asked states to ensure transportation services for workers and maintaining the supplies of the finished product.

In a letter to various departments, the health ministry has said the “situation calls for extraordinary measures” to make sure that TB patients do not face challenges in diagnosis or treatment.

Sudarshan Jain, secretary general of the Indian Pharmaceutical Alliance (IPA), said the production in pharma hubs like Daman and Baddi has taken a hit. 

“Macleods makes anti-TB medicine in Daman. Some production of the drug also happens in Baddi, which borders Punjab and Haryana. Many workers travel from these neighbouring areas, some had gone home. We have been requesting the government to allow the movement of essential commodities like pharma,” he said.

Once this is restored, supplies would normalise, Jain claimed.
 

The Centre is continuously taking stock of the production and inventory of key medicines in the country from the pharma industry.
 

Lupin is India's largest anti-TB medicine maker with an almost 63 per cent share of the market. In fact, four out of the top five anti-TB medicine brands belong to Lupin. It is also one of the biggest global suppliers for global institutions. Lupin makes the active pharmaceutical ingredient (API) too for the drug.
 

The private market for anti-TB drugs has been shrinking for the last few years, showing a negative growth and forcing manufacturers to focus on the government tender market.  India is committed to ending TB by 2025, five years ahead of the global target under the Sustainable Development Goals.
 

Nilesh Gupta, managing director of Lupin, had said in an earlier interaction, “We are one of the biggest suppliers for global institutions that buy drugs for TB. Even India has a significant purchase where we participate. In Ethambutol we account for 90 per cent of the global supplies, and 30 per cent of the global finished supplies.”
 

TB kills an estimated 480,000 Indians every year and more than 1,400 every day. India also has more than a million ‘missing’ cases every year that are not notified and remain either undiagnosed or unaccountably and inadequately diagnosed and treated in the private sector. In 2012 it was made mandatory to notify TB cases for both public and private sector providers.

Other major manufacturers include Macleods Pharmaceuticals, Cadila Pharmaceuticals and some smaller players like Concept Pharmaceuticals and Maneesh Pharmaceuticals.