The distribution of free drugs through sub-centres under the national programme for the control of Non Communicable Diseases (NCDs) is likely to be affected in the State following a ruling of the High Court that drugs may be distributed only through registered pharmacists at sub-centres.
Senior Health Department officials said the government would immediately seek a clarification from the Union Health Ministry on how drugs will be distributed through sub-centres under the national NCD control programme in future, as sub-centres do not have posts of doctors or pharmacists.
The High Court gave the ruling after pharmacists approached it with the charge that the government was violating S 42 of the Pharmacy Act by issuing a circular that at the sub-centres, JPHNs (junior public health nurses) may dispense drugs under the NCD control programme. The government’s argument is that the JPHNs are being used only to “distribute” the NCD drugs dispensed by pharmacists at the district level to patients coming to the sub-centres.
“The Union Health Ministry decided to bring the drugs to patients in sub-centres nearer their homes to ensure uninterrupted treatment. The guidelines of the NCD programme state that every sub-centre should have NCD drug stock for three months and that these are to be distributed through JPHNs,” a health official said.
Pharmacists’ case
The court, however, seems to have seen merit in the pharmacists’ argument that “the wrong dispensation of medicine or distribution of medicine by an unqualified person may lead to disastrous consequences.”
Health officials are concerned that the order could affect the drug distribution under national programmes — filariasis control, de-worming, iron and folic acid distribution, school health programme, and even the Revised National Tuberculosis Control Programme (RNTCP) — wherein the drugs are distributed by trained health workers.
The Kerala Government Pharmacists’ Association (KGPA) points out that such apprehensions are misplaced. “The order will not affect drug distribution under any of the national programmes involving mass drug administration. However, the common NCD drugs – for controlling blood sugar, hypertension or cholesterol – distributed under the national programme are to be dispensed only by a qualified pharmacist because a patient might be on several drugs and has to be monitored regularly,” says K.M. Muralidharan, general secretary, KGPA.
In other States
“The State government should see if a common pool of pharmacists whose services can be hired on need-basis can be created,” says K.G. Ravikumar, former Professor of Clinical Pharmacy, Thiruvananthapuram Government Medical College.
While it will not be feasible to appoint pharmacists in all sub-centres, one suggestion is that the panchayats appoint a pharmacist each so that he/she can be utilised for dispensing drugs for all health-related programmes implemented at the grassroots.