One of the critical aspects of the COVID-19 control is the timely supply of medical equipment & medicines. As of 28 July 2020, the central government has supplied more than 2.63 crore N95 masks, 1.19 crore PPE Kits and over 10.83 crore HCQ tablets to States & Central Institutions. The Central Government has also supplied around 60% of the ventilators allocated to the states.
With 1.86 crore confirmed cases and over 7 lakh deaths reported worldwide, the COVID-19 pandemic continues to worry nations. The third most affected country in the world in terms of number of cases, India’s COVID-19 tally crossed the 20 lakh mark on 07 August 2020, with over 6.07 lakh active cases. A total of 41,585 deaths have also been reported, as per the Ministry of Health’s update as of 07 August 2020. With 13.78 lakh recovered cases, the number of recovered cases is more than double the number of active cases.
One of the important strategies in fighting the pandemic is timely supply of medical equipment, personal protection equipment, medicines etc. to the affected areas. We look at the state-wise numbers related to these supplies in India.
Countries are resorting to unethical practices to get their share of medical equipment
When COVID-19 cases started getting reported across the globe in early March, WHO had stated that panic buying, hoarding, and misuse had put the lives of frontline healthcare workers at risk as the supply of personal protection equipment (PPE) including masks and gloves was limited. Even the wealthiest countries in the world had reported resource shortage. At one point of time, countries like Germany, Russia, Taiwan, Thailand, Kenya, and Czech Republic blocked the export of face masks, to overcome shortage. ORF had reported in May 2020 that countries resorted to unethical practices to get their share of medical equipment. Confiscating shipments, holding back other countries’ supplies, and last-minute outbidding are some desperate measures taken by countries, as per the ORF article.
As the number of cases soar, both globally and in India, the pressure on healthcare facilities is intensifying. There are numerous reports of hospitals facing shortage of medical equipment such as PPE Kits, test kits, beds, and ventilators.
In India, COVID-19 has now spread to rural areas from urban areas in many states. Healthcare in rural India is already faced with a chronic shortage in terms of workforce and infrastructure. Tackling COVID-19 will be a humungous challenge in the rural parts of the country.
Centre supplies required medical equipment and drugs to states
In India, the Central Government allocates and distributes medical supplies to each state. Data on state-wise supply of N95 masks, PPE Kits, Hydroxychloroquine (HCQ) tablets, and ventilators for COVID-19 purpose, by the Centre was obtained by Factly using Right to Information. The data used in the story is as of 28 July 2020.
The Central Government has sent more than 2.63 crore N95 masks to states, union territories and central institutions till 28 July 2020. More than 1.19 crore PPE Kits and over 10.83 crore Hydroxychloroquine tablets have also been distributed by the Centre. Central Institutions received the lion’s share of medical supplies.
Maharashtra has received largest number of medical supplies
Maharashtra, which also has the highest number of cases in the country, has received the largest number of N95 masks (24.46 Lakhs), PPE Kits (11.88 Lakhs), and HCQ tablets (97.2 Lakhs) as compared to other states.
Besides Maharashtra, the states of Gujarat, Delhi, and Uttar Pradesh, received more than 15 lakh N95 masks each. The total supply of masks to 20 states including the north-eastern states, Kerala, Himachal Pradesh, Punjab, and Bihar, is less than the number supplied to the four states of Maharashtra, Gujarat, Delhi & Uttar Pradesh.
In the case of PPE kits, Maharashtra, Gujarat, Uttar Pradesh, Madhya Pradesh, and Delhi have received more than 7 lakh kits each. These five states account for more than 41% of the cases in India and have received 37.5% of the PPE Kits distributed by the central government.
Meanwhile, the states of Maharashtra, Uttar Pradesh, Tamil Nadu, Delhi, Bihar, and Rajasthan received more than 60 Lakh HCQ tablets each. Together with Madhya Pradesh and Karnataka, the eight states alone received more than 51% of the tablets distributed by the Government of India (GoI). These eight states alone account for 77.7% of the reported deaths due to COVID-19 in India.
About 60% of the ventilators allocated have been delivered to states
A total of 25,406 ventilators were allocated to states and central institutions, of which 15,287 i.e. around 60% have been delivered. Maharashtra has been allocated the maximum number of ventilators- about 4,047, followed by Gujarat, Karnataka, and Andhra Pradesh, which have been allocated 2500, 2025, and 2000 ventilators each.
Mizoram, Puducherry, Tripura, Himachal Pradesh, and Arunachal Pradesh are the only states/UTs where the entire allocation has been delivered. Apart from these, 91% of the ventilators allocated to Delhi have also been delivered. Among the larger states, the delivery in Andhra Pradesh is the least, with only 28.5% ventilators delivered so far.
As per GoI, Medical supplies given to states based on request & need
Speaking to Factly, the Under Secretary, HPE Section of the Ministry of Health & Family Welfare (MoHFW), Mr. G K Pillai, said that ‘the basis (of distribution) is population and case load. Some states request more, and we give that- as per the request of states only. Some states request only a small quantity. Now, we have sent a letter informing states to indicate if there is a further need of ventilators, we will supply. We will not be supplying other material after 31 August. The supply will be done centrally only up to 31 August. After that, the states will have to purchase themselves. Only ventilator, we will supply’.
Ban on ventilators’ export has been lifted
While addressing the nation on 12 May 2020 and advocating Atmanirbhar Bharat (self-sufficient India), PM Narendra Modi stated that when COVID-19 began to spread in India, there was not a single PPE kit made in India. The N-95 masks were produced in small quantity in India. He further stated that India is in a situation to produce 2 lakh PPE and 2 lakh N-95 masks daily because India turned this crisis into an opportunity. When India went into a complete lockdown in March 2020, the GoI banned the export of ventilators, respiratory appliances, and sanitizers. Since then the production of medical kits required to tackle COVID-19 was ramped up.
Recently, in August 2020, the ban on ventilators export was lifted since the number of active cases requiring ventilator support has reduced. There has also been a substantial growth in domestic manufacturing capacity of ventilators and hence the lift in ban would help domestic manufacturers find new markets in other countries. However, restrictions still exist on export of individual items of the PPE kit.
States like Odisha have taken aggressive measures to ensure supply of medical equipment and drugs for next five months
Even states have come up with their own measures to ensure adequate supplies. As per an article on the World Bank blog, the Odisha State Medical Corporation Ltd (OSMCL) which is a state government enterprise, adopted a different approach to facilitate emergency procurement of medical supplies. An emergency procurement committee was set up by the government. Different inter-departmental committees were also constituted to monitor different processes from purchase, tracking movement, and authorization.
The committees took to aggressive approaches such as extending the existing contracts, renewing expired ones, single sourcing with or without tender inquiry, off the shelf purchase, and even fixing a ceiling price and selecting multiple suppliers at multiple rates to ensure that there is adequate supply of medical kits in the state. Special incentives were also announced for faster supply. Such measures enabled OSMCL to procure adequate quantity of essentials such as ventilators, PPE Kits, disinfectants, drugs, testing kits, beds, and consumables. Odisha now has a stock of five months’ worth supply of drugs and equipment.
Featured Image: Supply of medical equipment