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In the first week of July, LocalCircles received a series of complaints from relatives of several Covid-19 patients highlighting how they were struggling to procure anti-viral Remdesivir.
Some of them had been asked by the treating doctor to get more quantity in addition to what the hospital had already procured for them. When the relatives of patients approached chemists in their areas, they found the drug being quoted 400 to 900 per cent above the MRP (maximum retail price); they also had to wait a couple of hours for it. This was black marketing at its worst.
LocalCircles being a social media platform, the posts and comments were coming in thick and fast and so we escalated the issue to the authorities. Sure enough, within a few hours, the Union Health Ministry and the Drug Controller General of India took note and asked authorities across India to enforce a strict vigil against black marketing.
Chances are, this enforcement will continue for some time and when the next drug runs short, someone will have to escalate the issue of black marketing, again. This is because those who want to profiteer will find a way again while our complex enforcement system will take time to get flagged by someone and then get into action.
However, it doesn’t have to be this way. The Government, via DCGI, MOHFW and ICMR, must look at implementing mandatory end-to-end traceability with manufacturers of all critical and shortage-prone drugs and vaccines.
Insights from Boeing stint
Today, RFID or advanced barcodes have the ability to store data in the barcode and track the location of the object via a centralised system, allowing manufacturers to know in real time where every vial is.
In an earlier stint as Managing Director at Boeing, I have seen supply chains become more efficient by deploying real-time asset tracking. Having been among a few involved with introducing RFID to the US Department of Defence in 2005 for tracking their aircraft components, it was easy to imagine supply chains powered by technology.
While RFID would be nice to track medicines and vaccines, a relatively simpler barcode system would also work. A unique serial number can be put on every vial and the barcode is scanned at every step of the supply chain i.e. shipping from manufacturer, receipt at distributor, to receipt at the stockist/retailer and finally when the stock is issued by the retailer to the hospital/patient.
The final issuance would require the Aadhaar number of the actual patient and finally a digital signature by the doctor administering the drug or the vaccine. Since all the scanning devices are connected to the same central system, one would know where every vial’s serial number is in the supply chain. And such a system must not only be there for delivering the drugs and vaccines but also tracking unused quantities and directing them back to the stockist for issuance to another patient.
In the Remdesivir black marketing case, there was no traceability of whether the patients did not use all that was allocated for them.
In such a scenario, it is easy for any of those unused quantities to find their way from the hospital supply room or the pharmacy to the black market — finally forcing a consumer to pay ₹30,000 for a drug having a published MRP of ₹5,400.
Standardise the process
The Government should define this end-to-end traceability process and then standardise it, so before a licence is granted for manufacturing or importing a critical drug or vaccine prone to shortages, the pharmaceutical manufacturer or importer must demonstrate that such an end-to-end traceability process exists and will be implemented with the supply.
Similar plans in the past have fallen by the wayside, for reasons including concerns about cost to companies which, in turn, would have been passed on to the consumer. However, times have changed and if the tracking system cost is distributed over a million units or more, it would be well under a rupee per vial. Definitely worth it for all nodes of the supply chain and most definitely the end-consumer.
If we, as a nation, can define and standardise this process as a learning from the Remdsevisir black marketing incidents, we will be in a much better place to avoid the same when the Covid-19 vaccine does come out.
The writer is Founder and Chairman of LocalCircles, a community social media platform. Views are personal
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