NAVVNEET DUBEY
Jammu: In its audit report of 2022, the Comptroller and Auditor General (CAG) has raised serious questions about the availability of essential medicines in district hospitals across Jammu and Kashmir. According to the report, 266 drug formulations (in 28 categories) were notified in July 2019, but their average availability in the hospitals tested remained extremely low. In district hospitals in Anantnag, Handwara, Ramban, Udhampur, and Jammu, only 1 in 18 of 21 anesthetics were available. A maximum of 5 out of 7 analgesics/anti-inflammatories were available. Availability of life-saving medications like anti-allergy drugs and antidotes was also limited to 1-3. The report cited deficiencies in the implementation of the government’s revised Essential Medicines List (2019) as a major reason for patients facing difficulties in accessing treatment.
According to the report, out of 266 essential drug formulations, only 58 percent are available in Anantnag, 26 percent in Handwara, 13 percent in Ganderbal, only 11 percent in Ramban, 47 percent in Udhampur and 22 percent in Jammu.
Availability of several critical categories, such as anti-parkinsonism, vaccines, anti-retroviral drugs, and radiocontrast, was zero. In Ramban and Ganderbal, less than 25 percent of medicines were available in most categories. The report states that supplies of many of the 28 categories depend on contracts with the central government or the Jammu and Kashmir Medical Supplies Corporation, but poor enforcement is preventing patients from accessing medicines.
There is a shortage of essential medicines even in the sub-district and community health centres.
The audit report reveals abysmally low availability of essential medicines at Sub-District Hospitals (SDHs) and Community Health Centers (CHCs) across Jammu and Kashmir. According to the report, out of 214 notified drug formulations, only 9% were available at SDH Sogam in Anantnag and SDH Kupwara in Kupwara. This figure was 11% at SDH Jagti in Jammu and 19% at SDH Marh. The best-case scenario was at 50% in Dooru and 47% in Akhnoor, while availability at most centers ranged between 20-25%. The report cited the COVID-19 pandemic, low supplier shipments, and quality testing failures as reasons for the disruption in drug supply. This shortage is directly impacting rural patients’ access to affordable treatment.
The report of CAG also revealed serious irregularities in the purchase of surgical sutures. It has been said that Jammu and Kashmir Medical Supplies Corporation Limited gave undue benefits to a single supplier, Johnson & Johnson. The CAG report for the year ended March 31, 2018, stated that suture material worth Rs 25.48 crore was purchased from this single company between October 2017 and March 2018. Despite this, the performance audit found that the Jammu and Kashmir Medical Supplies Corporation continued to purchase Rs 9.68 crore worth of materials from the same supplier between 2019 and 2021.
According to the file noting, in the 2019-20 tender, the company quoted high rates for 130 items, which appeared to be impractical. The prices of other bidders also lacked clarity. It was unclear whether the price was per box or per piece. This created ambiguity in determining the lowest bidder.
The Jammu and Kashmir Medical Supplies Corporation subsequently requested the company to re-validate the old (2016-17) contract, arguing that this would ensure the availability of essential materials and protect the state’s interests. However, the CAG rejected this argument, stating that new tenders should have been issued to ensure fair competition.
In January 2025, the Corporation’s Financial Advisor/CAO responded, stating that the old rate contract was extended under duress in the interest of patient care and only after the approval of the competent authority. He also stated that a new rate contract was finalized in November 2021, involving both Medtronics India Private Limited and Johnson & Johnson.
