During the second wave of COVID-19 in India, we are witnessing more than just the government’s failure. We are witnessing apathy; we are witnessing black marketing and hoarding of essential medical supplies. Despite the urgent demand for oxygen and life-saving drugs, India is choking under the weight of bureaucracy and sluggish governance. Jaibatruka Mohanta details the despair of the desperate and the pitiful state of India.
By Jaibatruka Mohanta, a fourth-year student of B.L.S L.L.B at VKMs Pravin Gandhi College of Law, University of Mumbai.
On April 13, 2021, a young woman rushed from Hazaribagh to Jharkhand’s capital Ranchi to secure medical assistance for her CoVID infected father. Despite reaching out to the hospital, her cry for help fell on deaf ears. While she was still waiting for a bed in the hospital’s parking lot, her father gasped his last breath.
As India battles the second wave of coronavirus, the scarcity of oxygen, medicines and hospital beds intensified, meanwhile the Indian Health Minister claimed,
“India is better prepared mentally and physically this year with more experience to beat the CoVID-19 pandemic as compared to 2020.”
Funeral pyres, deceased and cramped ambulances waiting outside hospitals for medical care are enough to affirm our ‘preparedness’ to tackle the surge in COVID cases. Most hospital beds are accommodating way above the capacity. As people die unattended, instances of black marketing and hoarding essential supplies have hit the roof.
The present piece will analyse the black marketing of essential and life-saving drugs. It will focus on the administrative failure to curb malpractices. The piece will analyse the Indian government’s short-sightedness and ill-preparedness as it tries to salvage its position by fudging data. The article will also address the role and response of the Indian judiciary in this regard.
A Brewing Black Market
In Delhi, as the demand for Remedisvir injection soar, several incidents of fraud and hoarding came to the fore due to an unprecedented surge in cases. Although these life-saving drugs (including Remedisvir, Tocilizumab) require a prescription from doctors, many managed to procure the same through illicit means.
According to India Today, several vendors in Delhi and Gurugram claimed to sell one vial for about INR 20,000. This price is six times the price of the drug. Though the government had capped the price, it didn’t really consider such externalities.
Regarding this, the Bombay high court, in a suo motu Public Interest Litigation, came down heavily upon the government for the shortage of oxygen and non-availability of Remdesvir vials.
In its order, the court gave the government a three-hour window to supply 10,000 vials of Remdesvir to Nagpur district. The ruling added that the authorities could seek help from the police and raid the required depots in the city to ensure a smooth supply of medical requirements.
In many cities across India, COVID patients and their families are not able to get tested in time. In an attempt to downplay the crisis, some cases aren’t even reported. In this scenario, access to medical care is a privilege.
In Lucknow, the police conducted over a ten-day drive against hoarding and black marketing, recovering about 747 Remdesvir vials and 349 oxygen cylinders worth INR 11.5 lakhs. While the privileged can still afford a single Remdesivir vial at an exorbitant price of INR 1 lakh, the rest continue to struggle.
The Delhi Police also conducted a series of raids by taking help from police officials in other states like Bihar and Jharkhand to curb the black marketeers. Although it is a step in the right direction, however, a pre-planed distribution channel would have mitigated black marketing and hoarding in the first place.
A sting operation conducted in Delhi’s Yusuf Sarai market revealed illegitimate procurement and pricing of Remdesvir vials.
The rise in hoarding is also indicative of the government’s ill-preparedness for the second wave. It was only after the surge had become apparent that the government pushed for production.
Gasping For Breath
Despite efforts by the police, people are struggling to acquire oxygen cylinders, each of which could be priced at about INR 45 thousand. Though the oxygen supply was ramped up, it clearly didn’t meet the demand.
In Delhi, an ambulance had charged INR 10 thousand for a distance of four kilometres. Many such stories about unjustified and aggravated pricing and the lack of basic medical supplies have flooded the internet.
Black marketing is not new. In 2020, even Pakistan witnessed black marketing of blood plasma. In India, too, during the first wave of coronavirus, Remdesvir and Tocilizumb were short in supplies; however, they were available in bulk at Delhi’s black market.
All this has aggravated the number of deaths. Though the Centre claimed increased accessibility to manage the surge in demand, many states have denied a sharp rise in cases.
Uttar Pradesh’s government, for instance, seems to be living in denial. Apart from a severe scarcity of beds and medical attention, the state has reported missing people who were initially admitted to the hospitals.
As the hospitals insist on restricting relatives to meet the patient, it’s hard to know the latter’s whereabouts. For instance, in Lucknow, Uttar Pradesh, a family desperately trying to know the patient’s condition, only days after his death, found his body lying unattended at the crematorium.
Spiralling Shortage and Sluggish Response
In mid-April, Maharashtra, Gujarat and Delhi raised concerns about the shortage of Remdesivir. In response, the government halted the export of the life-saving drug.
Although seven pharma companies produce Remedesivir in India, the shortage sharply increased with the increase in cases. The main reason that the companies are unable to fulfil demand is that towards the end of the first wave last year in December, most manufacturers had stalled their production altogether. The same lead to a three-month lull with no Remedesivir output at all.
Manufacturers also scaled down the production of Remdesivir owing to the short shelf-life of the drug. Though the number of infections started snowballing, the unpreparedness of the government became more evident.
To salvage the situation, the Karnataka government issued Standard Operating Procedure (SOP) to use Remdesivir injections. The SOP stated that the batch number and daily dose administered to the patient be reflected in the patient’s case sheet. And the government ordered to regulate drug’s usage, constituting an expert committee of doctors for the same.
Despite the crunch in availability and rising demand, many in power are busy hoarding drugs without a licence to make political advances.
Gujarat BJP State Chief C.R. Patil claimed free distribution of Remedisvir injection while the State was facing a shortage of Remdisvir. In Maharashtra last month, opposition leader Devendra Fadanavis was alleged for obtaining Remedisvir injections as a private individual. Fadnavis claimed that he had arranged for the vials for Maharashtra, and the FDA approved the same. Why were these vials being hoarded in different parts of Mumbai by the manufacturer (Bruck pharma) in the first place?
As the crisis deepens, politics over critical drugs intensifies. Political arrogance, hypernationalism and majoritarian politics, together with bureaucratic lapses, are responsible for our failure.
High Courts Rising to the Occasion: Is That Enough?
High courts across the country have stepped up amidst the peak of the crisis.
For instance, the Madras high court reprimanded the Election Commission (EC) concerning a Public Writ Petition moved by Transport Minister MR Vijayabhaskar. The court pulled the EC for its loose response amidst rising cases; the court stated:
“You (ECI) are the only institution responsible for the situation that we are in today. You have been singularly lacking any exercise of authority…You have not taken measures against political parties holding rallies despite order of this court saying ‘maintain Covid protocol, maintain Covid protocol’ like a broken record.’
The court went on to ask the Election Commission’s counsel,
‘were you on another planet when the election rallies were held?’
In another case, Gujarat high court came heavily upon the state government over the jarring number of patients. After hearing the Advocate General regarding the steps taken by the government, the court said:
“the situation is quite different than what you are claiming. You are saying that everything is alright. But, the reality is contrary to that.”
The Delhi high court too directed the Delhi government to address the oxygen crisis rising in the capital. Concerning the hoarding and black marketing of oxygen cylinders and medical essentials, the court observed that this was ‘not the time to become vultures’.
While questioning the Delhi government, the court asked, ‘are you aware of black marketing. Is it a good human gesture?’ It also noted that the Delhi government’s entire system failed as black-marketing continued to rise sharply.
Though not as forthright as the high courts, the Supreme Court has become more active over the past couple of days. However, the critical question remains, can judgements and court orders aid the supply of medical essentials on the ground?
Although the judiciary has been proactively hearing pleas related to COVID-19, the same will not translate on the ground unless there’s administrative willingness.
Earlier in May, the Apex Court stepped in and stayed the Delhi high court’s contempt notice against the Centre. It directed the Centre to place a ‘comprehensive plan’ to ensure Delhi receives its quota of 700 metric tonnes of oxygen.
A step further would be to ask the legislature to issue ordinances that prohibit black-marketing and exorbitant prices for essential medical facilities and ensure the capacity-building of healthcare workers.
As 2021 is also slowly slipping away, the failure on the government’s end is becoming more evident. People are losing patience; families of patients are tired of making endless calls and standing in long queues. Everyone is figuring out the best possible way to deal with the situation. Owing to such helplessness, many have resorted to procuring requirements from hoarders and black marketeers.
From hospitals to cremation grounds, the agony is just multifold. The irony is that most people are dying not just because of COVID but also because of the inaccessibility due to black marketing and hoarding.
But one can’t blame people who have succumbed to black marketing due to the lack of government’s support. The government and years of systemic failure should be held liable for fueling such malpractices.
In a horrific state of affairs, forty kilometres away from India’s capital, families claimed that doctors and medical staff abandoned the hospital owing to oxygen shortages. Due to which six patients lost their lives.
This is unprecedented. While several nonprofit organizations have extended help and humanity, we also witness the inhumane.
As health infrastructure begins to rupture, office-bearers are busy burying its debris. It’s only appalling that people out there intend to exploit death and misery in desperate time like these.
We must remember this time as the time of our collective humanity and the time of insensitivity of a failing state.
Covid patient dies at gate of Ranchi hospital; wailing daughter blames health minister, April 14, 2021, India Today, https://www.indiatoday.in/coronavirus-outbreak/story/-covid-patient-dies-at-gate-of-ranchi-hospital-wailing-daughter-blames-health-minister-1790707-2021-04-14
India better prepared this year to beat COVID-19 compared to 2020, says Harsh Vardhan, April 27, 2021, The Hindu, https://www.thehindu.com/news/national/union-health-minister-harsh-vardhan-press-conference-on-april-27-2021/article34422834.ece
India’s Covid-19 shortages spur the black market for drugs, oxygen, April 22, 2021, The Economic Times, https://economictimes.indiatimes.com/industry/healthcare/biotech/healthcare/indias-covid-19-shortages-spur-black-market-for-drugs-oxygen/jacked-up-prices/slideshow/82194582.cms