Lok Sabha Question No. 1842 (UNSTARRED), answered on 2021-07-30
Subject: Hoarding and Illegal Sale of Medical Equipments during COVID-19
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Vincent H Pala, Adoor Prakash, Faizal P.P. Mohammed, Gaurav Gogoi, Kalyan Banerjee, T.N. Prathapan, Behanan Benny, Amar Singh, Kumbakudi Sudhakaran, M. Selvaraj, A. Chellakumar, D.K. Suresh

## GOVERNMENT OF INDIA

## MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED Q. No 1842 th

TO BE ANSWERED ON 30 JULY, 2021

## HOARDING AND ILLEGAL SALE OF MEDICAL EQUIPMENT DURING COVID - 19

## 1842 SHRI VINCENT H. PALA :

ADV. ADOOR PRAKASH :

SHRI MOHAMMED FAIZAL P.P.

SHRI GAURAV GOGOI :

SHRI KALYAN BANERJEE :

SHRI T.N. PRATHAPAN :

SHRI BENNY BEHANAN :

DR. AMAR SINGH :

SHRI KUMBAKUDI SUDHAKARAN :

SHRI M. SELVARAJ :

DR. A. CHALLAKUMAR :

SHRI D. K. SURESH :

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state

- ( a) whether  the  Government  maintains  record  of  deaths  caused  by  lack  of  availability medicines, medical equipment like oxygen cylinders and lack of oxygen in hospital;
- ( b) if so, the number of deaths caused by lack of medicines, medical equipment, nd lack of oxygen in hospitals from March 1 st 2021,to till date, State/UT - wise;
- ( c) whether the Government intends to build on such a database, if so, t he details thereof;
- ( d) whether the Government has ordered an inquiry on such deaths, if so, the details t and the outcome thereon; and
- ( e) the number of people charged for illegally hoarding and selling medical equipments oxygen cylinders and medicines between May 1, 2020 and May 31, 2021 along with the corresponding data for the same period in 2019 - 2020 separately?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARTI PRAVIN PAWAR)

(a) to (e) :Health is a state subject. Detailed guidelines for reporting of COVID - 19 deaths have been  issued  by  Union  Health  Ministry,  to  all  States/UTs.  Accordingly,  all  states/UTs COVID cases and COVID deaths to Union Health Ministry.

ICMR on 10 th May 2020 issued 'Guidance for appropriate recording of COVID - 19 related deaths in India' (Available at: ance\_appropriate\_recording\_of\_related\_deaths\_

https://www.icmr.gov.in/pdf/covid/techdoc/Guid India.pdf ). This was widely disseminated among states/UTs.

MoHFW  vide  letter  dated  9 th October  2020  has  conveyed  to  States/UTs,  WHO  and ICMR guidelines on correct recording of COVID - 19 related deaths in accordan ce with globally accepted ICD - 10 classification. In addition, the issue of correct and timely reporting o has also been stressed to all States/UTs through multiple video conferences including VC on 12 th October, 2020; 05 th December 2020; 22 nd June 2021.

The COVID - 19 management toolkit for District Collectors shared by Ministry of Heal &  Family  Welfare  on  2 nd April  2021  with  states,  highlighted  the  need  for  deaths  audits  a follow up action as one of the key monitoring parameters.

166  Centra l  teams  deployed  to  33  states/UTs  have  also  reiterated  need  for  corr recording of deaths.

The data on number of deaths are obtained from States/UTs. All states have someti also been advised by the Ministry of Health and Family Welfare that while reco nciling the death data at the State level, the number of deaths shall be indicated date wise & district wise

Although  health  is  a  state  subject,  Government  of  India  has  provided  the  requ technical  support  and  has  also  supported  the  states  through  log istic  and  financial  support  to further strengthen the existing health infrastructure to tackle COVID - 19 pandemic.

Some of the ongoing initiatives to further strengthen healthcare infrastructure incl

- With the intent to reduce the risk of cross infectio n to non - COVID  patients  as  well  as  to maintain  continuity  of  non - COVID  essential  health  services  in  the  country,  a  three - tier arrangement of dedicated COVID - 19  health  facilities [(i) COVID Care Center (CCC); (ii) Dedicated COVID Health Centre (DCHC) and (i ii) Dedicated COVID Hospital (DCH)] has been implemented in the country.

- Government of India, to supplement the hospital facilities has roped in tertiary care under ESIC, Defence, Railways, paramilitary forces, Steel Ministry etc. Further, many large temporary  treatment  facilities  were  established  by  DRDO  to  manage  surge  in  COVID - 19 cases in the country.
- The isolation bed capacity and ICU bed capacity which was only 10,180 and 2,168 before first lockdown (as on 23 rd March 2020) in being enhan ced continuously and is currently at 18,21,845 isolation beds and 1,22,035 ICU beds (as on 20 th July 2021).
- The  daily  liquid  medical  oxygen  (LMO)  supply,  which  was  about  1292  MTs  per  day  in February 2021 increased to 8593 MTs in April 2021. On 28 th May 2021, a total of 10,250 MTs of LMO was allocated to the states. This was done by enhancement of LMO production in steel plants as well as in other LMO plants.
- Restrictions were imposed on industrial use of oxygen.
- A dynamic and transparent framework for al location of medical oxygen in consultation with States/UTs and all the stakeholders such as relevant Ministries, manufacturers/suppl liquid oxygen etc. was prepared.
- Online  digital  solutions  viz.  Oxygen  Demand  Aggregation  system  (ODAS)  and  Oxygen D igital Tracking System (ODTS) have been developed to ascertain the demand for medic oxygen from all medical facilities and to track their transportation.
- To avoid wastage of medical oxygen, guidelines on rational use of oxygen were issued 25 th September 2020, and further revised and disseminated to States on 25 th April 2021.
- 1,02,400 oxygen cylinders were procured in April and May of 2020 and distributed to St Further  orders  for  additional  1,27,000  cylinders  have  been  placed  on  21.04.2021  (54 jumbo cylinders (D type) and 73,000 regular cylinders (B type). Deliveries of the same started and 53,056 (40,729 B - type and 12,327 D - type) cylinders have been delivered as on 26 th July 2021.
- To  generate  oxygen  at  the  health  facility  level,  PSA plants  are  being  established  in  each district hospitals, especially in far flung areas enabling the hospitals to become sel - sufficient in generation of oxygen for their needs and thereby, reduce the burden on the medical o supply grid across the coun try.
- Further, to fast - track the availability of Medical Oxygen in rural and peri - urban areas, more than 39,000 Oxygen Concentrators have been allocated to various States.
- A  COVID  Drugs  Management  Cell  (CDMC)  has  been  set  up  in  the  Department  of Pharmaceut icals  (DoP)  to  oversee  the  management  of  smooth  supply  of  drugs  used  in COVID - 19 management.
- Action is initiated at the National level to augment production of critical drugs import besides support in terms of equitable distribution of the criti cal supplies.
- A Drugs Coordination Committee (DCC) has been constituted as an institutional mechanis under Department of Pharmaceuticals for efficient decision making on all the issues respect  to  COVID - 19  related  drugs  including  availability  through inter - departmental consultations.

- Remdesivir is a patented drug, manufactured in India under voluntary licenses grant Gilead  Life  Sciences  USA  (the  patent  holder)  to  7  Indian  pharmaceutical  compani Manufacturing  capacity  was  augmented  from  38  lakh vials  per  month  in  March  2021  to nearly 122 lakh vials per month in June 2021. In addition, 40 additional manufacturin were approved by the CDSCO, thus increasing the manufacturing sites from 22 (in Marc 2021) to 62 (June 2021).
- All States/UT and S tate Drugs Controllers have been requested to verify stock of the d and check other malpractices and take effective steps to curb hoarding and black mark of Remdesivir.
- Department  of  Pharmaceuticals  and  the  Drug  Controller  General  of  India  (DCGI) have actively  coordinated  with  the  industry  to  enhance  availability  of  Amphotericin  B  th identification of manufacturers, alternate drugs and expeditious approvals of manufacturing facilities.
- Besides, the existing five manufacturers, DCGI had is sued permissions to manufacturing / marketing of Amphotericin B Liposomal Injection to six additional firms.
- Ministry of Health & Family Welfare continues to provide technical guidance for manag various aspects of COVID - 19. So far more than 150 guidelin es/advisories/SoPs/plans have been provided to States/UTs.
- Taking note of ingress of COVID - 19  pandemic  in  peri - urban  and  rural  areas,  Ministry  of Health & Family Welfare on 16 th May 2021 issued an SOP on COVID - 19 Containment & Management in Peri - urban, Ru ral & Tribal areas.
- Further COVID- 19 treatment protocols and advisories both for adults as well as pediatri groups were issued and widely disseminated to promote rational use of drugs and oxygen.
- Union Ministry of Health and Family Welfare has reques ted all States/UTs health officials and licensing authorities through advisories to instruct their enforcement staff to k vigil especially at sensitive places and to take stringent action against any black - marketing by conducting special drives f or monitoring and investigation.
- Enforcement actions like seizures, arrests of accused persons / registration of FIR e been carried out by the State Licensing Authorities.