Drug Supply Shortage in India During COVID-19 Pandemic: Efforts and Challenges

With the clock ticking and an impending doom that India might face, radical interventions are necessary. There is a dire need to strengthen the supply chains by bringing in experts, diversifying the procurement through introducing duty-free imports and exempting domestic taxes, strategically stockpiling the product, and even dilution of intellectual property (IP) regulations. Any innovative product like drugs, vaccines, medical devices or other medical supplies are legally protected by patents enabling the right holders to protect their IP against third-party use [10].

The ongoing COVID-19 crisis has created a growing need to enable the country to manufacture essential medical supplies. Thus to counter this pandemic, there is an ardent need for the government to intervene and dilute the IP restrictions for a short-term to ensure effective deployment of medical supplies for public health and safety [11]. This is achieved by following the regulations on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) which includes certain tools like compulsory licensing that are available to ensure access to medicines [12]. After fulfilling certain prerequisites that are stipulated in the Indian Patent Act, the government, by way of issuance of compulsory license, can authorize or permit a third party to use an invented product or process which has been patented [13].

Another method by which effective dissemination of products related to public health can be ensured is by creating a global patent pool of COVID-19 related innovations, that could be managed by a trustworthy international organization. All countries should have the right to implement these innovations without the need for permission from the patent-holders or use of tools such as compulsory licensing, state acquisition, among others. This method of pooling of patent resources is also in line with the Doha Declaration on the TRIPS Agreement and Public Health [11,12].

The government also needs to improve the process by relaxing restrictions and enforcing legislations associated with drug export and making sure the drugs are at par in terms of their quality. With cases rising at an all-time high, the restrictions on shipping of products should be relaxed and the associated delays and costs need to be addressed with utmost urgency [14]. India also needs to produce raw materials locally in order to meet the rising demand and to counter the restrictions imposed by the heavy import of APIs from China.

Effective drug procurement and distribution should also be attained to deliver on the promise of Universal Health Assurance. The government and pharmaceutical industries could partner to revive the Jan Aushadhi programme and help deliver high-quality and affordable generic medicines. With a rising mortality rate and a collapsing health system fuelled by drug shortages, an increase in production of generics is the need of the hour. Ramping up the production is the only way to deliver drugs to the patients at the earliest. With the incurring benefit, this would also facilitate medical and drug research in the country.

While the government ensures equitable access to medicines for everyone, there needs to be a substantial return on the investment and a predictable and transparent policy environment that will foster more medical innovations. Indian drugs rank among the cheapest in the world, differing by 65% and 25% respectively from their counterparts in BRICS states and SAARC countries [15]. In this scenario, India needs to augment its financial outlay with the sole and stated objective of raising public health spend. By regulating the land and utility prices, the country can attract pharmaceutical industries from abroad to set up their units, helping small and medium-sized industries thrive by encouraging fast-track approvals. This will, in turn, also help relieve the country’s reliance on foreign raw materials [16]. Introducing policies such as duty-free imports and exemption from domestic taxes for various manufacturers engaged in exports will also help significantly in generating revenue [17].

It is necessary for these recommendations to be implemented by the National Institution for Transforming India, also known as NITI Aayog, which has the ability to span across ministries and withstand populist pressures. The NITI Aayog, along with the Department of Pharmaceuticals, has recently planned an incentive scheme of Rs 3,000 crore to revive domestic manufacturing of bulk drugs and this certainly looks like a step towards a better future [18].