Bombay High Court Asks Why Local Alternatives Are Not Publicised Enough

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The Bombay High Court on Thursday asked why the Union and State Government didn’t publicise alternatives to imported drugs used for treating Covid-19 patients.

“The reasons to popularise foreign medicines are obvious. But if we have alternatives, why not use local medicines. It’s right there. You don’t even need Hanuman.” the bench of Chief Justice Dipankar Datta and Justice GS Kulkarni said, referring to how the Sanjeevani, a local medicinal plant, had helped Lakshman in the Hindu epic Ramayana.

“None can be allowed to profit from the sale of essential drugs. It is you, the central government and you, the state government. You have to put your foot down. India is not a country for foreign companies to make profits like this.”

The bench heard a clutch of PILs on Covid-19 management in the State, when advocate Rejesh Inamdar for a petitioner, pointed out how patients were dying due to the non-availability of investigational drugs like Tocilizumab and Faviparavir, especially outside Mumbai.

“There is a severe shortage of Tocilizumab, not just Remdisivir. Young people are dying because of the shortage of this drug. Government Hospitals in Pune are asking patients to arrange for this drug from outside,” Inamdar submitted.

Swiss company ‘Roche’ manufactures Tocilizumab and its marketed by Cipla in India, the court noted.

It then cited the Union’s affidavit to the Supreme Court, in which the Centre claims that domestically produced alternatives of Tocilizumab such as itulizumab, dexamethasone and methyl prednisolone are equivalent or more effective. The affidavit adds that it’s a misconception that only Tocilizumab can treat the inflammatory burst condition in covid-19 patients.

The Union’s affidavit reads as under,

It is listed as an investigational therapy drug (off-label) under the National Clinical Management Protocol for COVID-19 for severe cases. There are domestically produced alternatives which are equivalent to or better than Tociluzumab such as itulizumab, dexamethasone and methyl prednisolone. However, an incorrect public perception has been created that only Tociluzumab can treat the inflammatory burst condition in COVID19 patients since it is an imported drug. This has led to the acute shortage in the availability of the drug and has created public panic.

The bench noted that Union’s submissions on alternatives to foreign drugs were mentioned in the Supreme Court’s order.

Inamdar prayed that this must be conveyed to doctors who continue to insist on expensive imported drugs only.

The court said it would issue specific directions in its order.

Replicate Mumbai model in other districts

Noting the decline in covid-19 cases in Mumbai and the availability of beds, he Chief Justice asked the Civic Chief Iqbal Chahal to take a video conference meeting with heads of other civic bodies, and discuss the model followed.

The bench suggested that since Mumbai has 12,000 beds available, it could probably share Pune’s load, which has double the number of cases. While Mumbai has 86,000 active cases, Pune has 1.4 lakh cases.

The AG informed the bench that Pune was facing medical migration, where people from other districts were visiting for treatment.

The court suggested a lockdown in Pune to control the number of active cases. The AG said, “Sir, people don’t wear even a helmet forget the mask.”

He, in turn, requested the court to order a lockdown.

“We don’t want to cross our boundaries. We are aware of Allahabad HC order of lockdown in five cities and the SC quashing it,” CJ said.

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