The NPPO should aim to promote availability and accessibility to quality medicines.
By Prof. Bejon Kumar Misra
India has been significantly hit by the Covid-19 second wave and the aftermath has heightened the urgent need for medical and scientific advancements to foster our longevity and well-being. During this time, the sense of urgency was aided by the government issuing the New Public Procurement Order (NPPO) to support the “Make in India” initiative. The main idea was to promote accessibility, manufacturing and production of goods and services in India thus encouraging higher growth in income and employment.
However, the focus on patients was missing in the NPPO as the healthcare delivery system and accessibility to medicines should have been highlighted and thus exempted from this order to enable patients to access medicines without any discrimination as the proposed policy could prove to be detrimental at a vital time as this pandemic. India has produced medical generics, vaccines and consumables to export to other countries, and preventing the inflow of raw materials in the field of biological and pharmaceutical fields can prove to be calamitous to patients’ lives and needs to be looked into urgently.
PPO: Interrupting Supply of Critical Drugs
During the pandemic, a few key measures were taken to mitigate its impact on India’s economy. One of these included Atmanirbhar Bharat—a self-reliant initiative launched by Prime Minister Narendra Modi. Differing interpretations of the initiative by the government spurred the introduction of a NPPO that impedes the availability of life-saving, specialty, and proprietary drugs that are not manufactured locally or rely on ingredients not locally available.
According to the New Public Procurement Order (NPPO), non-local suppliers’ (suppliers with local content less than 20%) will be rendered ineligible to bid in government procurement, except for Global Tender Enquiry (GTE), which has a threshold of Rs 200 crores. The NPPO, as passed by the government, can prove to be detrimental in this time of global crisis when the nation needs exemplary medical and health infrastructure to support its needs. We must assure non-discriminatory access and it is the responsibility of the State to assure availability of medicines as prescribed by the medical practitioners. Interrupting the supply of essential drugs can impact the quality of patients’ lives .
Raising Barriers to Accessibility of Reliable Patient Care
NPPO has been issued as a pan-industry directive by the DPIIT (Department for Promotion of Industry and Internal Trade) to make India self-reliant or ‘Aatmanirbhar,’ which is a laudable aim. However, sectors such as the pharmaceutical industry, which rely on imports for highly specialized, life-saving, drugs and targeted therapies – complex biologics, orphan drugs, and more, must be exempted as it is critical to ensure that patients have access to these essential medicines. Without further clarification or revisions to the current PPO, the availability of critical drugs, which aren’t manufactured locally, can be affected, thus impacting patients in need of critical care and immediate attention.
The current PPO will encourage the advancement of spurious and Not of Standard Quality (NSQ) medicines and prompt the entry of unscrupulous drugs into the supply chain, posing further challenges to a suffering population in dire need of safe and reliable medical care.
Moreover, should the industry fully adopt the latest NPPO, it will give rise to strong suspicions on the quality, availability, cost, and efficacy of pharma products provided to the patients. This can be extremely dangerous, particularly for impeding vital treatments.
Fostering Patient Centricity
The NPPO should aim to promote availability and accessibility to quality medicines. Issuing clarifications and clear guidelines that streamline a value-added supply chain of medicines instead is necessary to effectively support patients, particularly those already feeling helpless and isolated by the reduced access to life-saving medicines to treat their conditions. Facilitating patient well-being is one of the core tenets of our sector, and thus we must aim to undertake any measures necessary to ensure a renewed and continued focus on patient centricity.
We need to act, and act urgently. We need the NPPO to enable us to focus on the issues that perpetuate inequality locally and globally. We want to support civil societies to play an active role in tackling inequality in their local areas. We want to encourage researchers to share what they know about inequality in accessing quality healthcare, including practical ideas about how to tackle this. The current focus should be to uphold patient well-being and the rights of all the nation’s citizens by ensuring those in need of medical attention have access to the medical aid available, without any impediments.
The Way Forward
Within such public procurement orders, medicines and healthcare goods cannot be treated at par with electronics, digital items, and other manufacturing goods, since any consequent delay in manufacturing or supply of such products could mean life-threatening consequences to patients. The need of the hour is for the Government of India to intervene and introduce amendments to the order that is in line with patient needs.
We are again in the midst of another global crisis that is resulting in widening health, economic and social inequalities. Today our campaign on Universal Health Coverage (UHC) provides an opportunity for us to come together and act together to highlight how inequality can be addressed to ensure people are able to enjoy quality and safe healthcare. India should continue to work towards being locally sufficient and reducing its dependency on foreign markets.
However, in the case of healthcare, it is vital to exempt the public and private healthcare providers and pharmaceutical industry from the NPPO for the overall betterment of patients’ health and wellbeing. Ensuring uninterrupted access to medicines, therapies, and health support are imperative in the interest of patient safety and welfare.
(The author is Founder & Director, Patient Safety & Access Initiative of India Foundation. The article is for informational purposes only. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)
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