Form policy to issue black fungus drug: HC tells Centre, Delhi Govt
The bench said it is an issue which neither the Centre nor the state government can duck and it is a decision that the political leadership will have to take in consultation with medical experts without leaving it only to doctors who may face the wrath of the patients' relatives.
New Delhi: The Delhi High Court Monday asked the Centre and Delhi government to come out with a policy on distribution of Amphotericin-B, used for treating black fungus patients, and take the "cruel decision" of excluding certain age group or class of people till the drug is in shortage.
The bench said "we follow the practice of 'Vasudev Kutumbakam' which means the world is one family but if there are two patients in a family who need the medicine and you have one dose, you have to chose one member".
The bench asked them not to leave the decision to the doctors and form a clear policy in this regard and told the counsel for the Centre and Delhi government to come back with instructions on Tuesday.
Citing an example, it said that if there are two patients -- one is 80-year-old and other is 35-year-old — and there is only one dose of medicine then it should be given to whom.
"That's a bullet you have to take it" and "you have to take this cruel decision" which is not at all an easy task, said a bench of Justices Vipin Sanghi and Jasmeet Singh, making it clear that it was not at all saying life of any person is less important than another.
"Every life is important but we are trying to find a way forward. Every life is important, we are not for a moment saying someone's life is not important or less important. But you have to take a decision. Every single life is important," the bench said.
It said it is an issue which neither the Centre nor the state government can duck and it is a decision that the political leadership will have to take in consultation with medical experts without leaving it only to doctors who may face the wrath of the patients'' relatives.
Senior advocate Rahul Mehra, representing the Delhi government, said they were following the formula of Centre to allocate the vials on pro-rata basis and let the Central government change its formula, the state will change its system.
The court also told the Centre's counsel that as a matter of policy, the government will have to say till the drug is not available in appropriate quantity, it will have to leave some patients and "you have to exclude some".
"The 80-year-old man has lived his life, he has no more responsibility, of course there is a support from his side to the family. Whereas, the 35-year-old patient has two children to support. If we have to make a cruel choice, we have to take a decision. Will you give it to the 80-year-old patient or to whom who has two children to support," the bench said.
Central government standing counsel Kirtiman Singh said for non-centre hospitals, states have to take the decision and even states will know the patient load.
To this, the bench said, "You have to prioritise. There is scarcity of the medicine. You will have to make that list. You are making allocation from central pool. It has to be on the basis of priority."
It said if a patient requires six vials to beat the fungus, the government cannot say make do with two doses.
"Neither Centre nor state government can duck it. It is a decision that the political leadership will have to take in consultation with medical experts. Why you are leaving the decision with the doctor. He will be lynched by four others in the hospital," the bench said, adding politically it will be good for both for them, the Centre and the state.
It said the government has to take the decision whether to give it to 80 plus, 75 plus of age group or not as today everyone is suffering across the board and if a person does not get six vials a day, it could be fatal.
The bench said distributing two vials each to everyone is not helping anyone and said giving medicine on pro-rata basis was not acceptable and asked the counsel to come with instructions on Tuesday.
The court has been hearing the issue of shortage of the medicine for treating black fungus, primarily affecting people who have recovered from COVID-19.
The court has also asked the Centre to place on record the details of current status of its imports of the drug and when the stocks are expected.
According to the Union Health Ministry, people catch mucormycosis by coming in contact with the fungal spores in the environment. It can also develop on the skin after the fungus enters the skin through a cut, scrape, burn, or other type of skin trauma.
The disease is being detected among patients who are recovering or have recovered from COVID-19. Moreover, anyone who is diabetic and whose immune system is not functioning well needs to be on the guard against this, the ministry has said.